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Treatment of a Large Periradicular Lesion of Endodontic Origin Around a Dental Implant With Enamel Matrix Protein Derivative.

Lin S, Mayer Y

* Endodontics and Dental Trauma Unit, Department of Oral and Dental Medicine, Rambam Medical Center, Haifa, Israel., † Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel., ‡ B. Rappaport – Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel., § Periodontal Unit, Department of Oral and Dental Medicine, Rambam Medical Center.

Background: This case report describes the healing of a large periradicular lesion involving an adjacent implant. Endodontic surgery was performed in combination with placement of an enamel matrix protein derivative. Methods: Endodontic surgery was performed, including root end resection at a 90 degrees angle. Ultrasonic tips were used for retrograde preparation, and the retrograde cavity was sealed with zinc oxide-eugenol. The area was filled carefully with enamel matrix proteins. Sutures were removed after a 2-week healing period. Results: There were no symptoms of pain, inflammation, or discomfort at 18 months post-surgery. Radiographs showed complete healing of the periradicular lesion. Conclusions: Combining an enamel matrix protein derivative with conventional surgery may improve the clinical outcome of large endodontic lesions. Additional research is warranted.

Published 6 December 2007 in J Periodontol, 78(12): 2385-2388.
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