Use Of Biomaterials In Restoring Large Periradicular Bone Defects: A Case Report

Aggarwal, Nidhi; Sibal, Nikhil; Batra, Ranmeet; Jindal, Vikas
December 2011
Indian Journal of Dental Sciences;Dec2011, Vol. 3 Issue 5, p61
Academic Journal
Case Study
This case report presents a rare treatment modality employed for treating a large peri-radicular bone defect which had led to Grade-III mobility in relation to mandibular anterior teeth. The treatment involved the use of Mineral Trioxide Aggregate (MTA) biomaterial for a retrograde filling and as well as filling up the peri-radicular bone defects. A 15-year-old female patient was referred to the endodontic clinic as a result of large periapical swelling in relation to the mandibular central incisors prevailing for over a period of two months. Radiographic examination revealed complete destruction of buccal bone plate. Conventional root canal therapy along with apicoectomy was performed, and a root-end cavity was prepared and restored with MTA as a retrofilling material. Simultaneously the MTA was filled up in the bony defect and the teeth were splinted with a composite splint. Periodic radiographic and clinical examination was carried out which demonstrated considerable healing and the splint was removed after five weeks. Nine months after the periradicular surgery, there were no clinical or radiographic signs suggestive of treatment failure, instead the patient's follow-up has demonstrated that the case management has been successful as indicated by lesion regression and periodontal repair accompanied with no mobility what so ever. MTA was chosen as a result of its ability to provide an excellent marginal seal and due to its capacity to induce cell response which leads to the adherence of osteoblasts to MTA. Literature has reported that MTA facilitates the regeneration of periodontal ligament and formation of bone. On the basis of the review of literature and the clinical-radiographic outcomes of the case presented, it can be concluded that, large bone defects caused by peri-radicular lesions could be filled with a recognizably effective osteo-inductive and osteoconductive biomaterials such as MTA.


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