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Guided Tissue Regeneration in Surgical Endodontic Treatment: Case Report and Literature Review

Summary Background/Aim: Guided tissue regeneration is widely used in endodontic surgery. The aim is to aid in the healing process and bone regeneration and provide more successful and predictable outcomes. Case report: This case report describes the successful treatment of an endodontic-periodontal lesion (with primary endodontic involvement), including root canal retreatment and endodontic surgery with the use of GTR (collagen absorbable membrane-xenogeneic bone graft). CBCT examination was used to aid in diagnosis and in the follow-up examination after two years to provide additional confirmation of the healing process. An extensive literature review was undertaken focusing on clinical studies that assessing the added benefit of GTR in surgical endodontics. The clinical and radiographic examinations showed uneventful healing and the reconstruction of the buccal plate and periapical area. The patient remained asymptomatic throughout the entire two years period after surgical intervention. A literature review concluded that lesion type, lesion size and the selection of the biomaterial are important factors that influence the outcome of GTR in comparison control groups. A favorable outcome was found in cases of large periapical lesions (>10mm), through-through lesions and with the use of an absorbable membrane, with or without a bone graft. Conclusions: GTR is thought to provide an added benefit in bone regeneration and the healing process in specific cases. The outcomes in the case report are consistent with the conclusions of literature review.