Long-term outcome of endo-surgical treatment of chronic apical periodontitis – case reports

Background.Improvement in the biological qualities of blood products (change of centrifugation protocols, type of apparatus, type of test tubes) and surgical techniques might enhance endodontic surgery's outcome and the healing process.The local application of plasma-rich fibrin has been advocated to enforce bone regeneration and soft tissue healing after oral surgery.Purpose.This article aims to monitor the long-term effect of combined endodontic and surgical treatment of chronic apical periodontitis in two patients and to assess the potential benefits of using platelet-rich fibrin (PRF) as a treatment modality in modern endodontic surgical procedures.Material and methods.Two patients with chronic apical periodontitis were presented.Root canals of affected teeth were treated and filled with Thermafil (Dentsply, Maillefer) and sealer epoxy sealer (AH plus JET, Dentsply, Sirona, Germany).During the surgery in postoperative defect was administered platelet concentrate A-PRF according to the Schoukroun protocol.Results.The long-term follow-up indicates full recovery of periapical changes and excellent functional outcomes.In addition, radiographic healing was detectable earlier in the cases and as complete healing after six months. Conclusion.The adjunctive use of A-PRF in the endo-surgical treatment of chronic periapical lesions might promote the acceleration of healing and excellent long-term result.