The re positioned window technique appears to be a good osteoconductive barrier for bone formation. Its osteogenic potential needs to be confirmed immunochemically. High-temperature sintered bovine bone proved to be an effective slowly resorbing osseoconductive material.

Introduction The purpose of this prospective clinical study is to evaluate the clinical outcome of endodontic microsurgery on roots exhibiting the presence or absence of dentinal defects at one year and three-year follow up period. Methods 155 teeth were treated with periapical microsurgery using a modern microsurgical protocol in a private practice setting. The root apices were resected and inspected for dentinal defects with a Surgical Operating Microscope and a 0.8mm head diameter LED microscope diagnostic probe light. After inspection, retrograde preparations were performed using ultrasonic tips and retrograde fillings were placed. Follow up visits occurred at one year and three years post-operatively. The primary outcome measure employed was the change in the radiographic apical bone density and the secondary outcome measure used was the absence of clinical symptoms. Results Out of the 155 treated teeth, a total of 134 teeth were assessed at the one-year follow-up and 127 teeth at the three-year evaluation. The “Intact” group had 94.8% healed at one year and 97.3% healed at three years. The “Dentinal Defect” group had 29.8% healed at one year and 31.5% healed at three years. The baseline root condition of either “Dentinal Defect” or “Intact” showed a statistical difference in the healing outcome at both one year and at three years. Conclusions This prospective periapical microsurgery study showed a significant superior clinical outcome for intact roots when compared to roots with dentinal defects at both 1 year and at 3 years post-operatively.

This study investigated the effect of potent intracanal corticosteroids on periodontal healing of replanted avulsed teeth and evaluated the systemic absorption of these corticosteroids. Sixty-seven extracted dog premolar roots were randomly assigned to one of the following groups: groups 1-3 filled with gutta-percha and replanted immediately and after 40 and 60 minutes, respectively; groups 4 and 5 filled with 0.05% clobetasol; and groups 6 and 7 filled with 0.05 % fluocinonide. Groups 4 and 6 were replanted after 40 minutes and groups 5 and 7 after 60 minutes. After 4 months, roots were evaluated histologically for signs of periodontal healing. Roots treated with clobetasol and fluocinonide healed more favorably than roots filled with gutta-percha and were different from each other at 60 minutes. No change in the systemic corticosteroid blood concentration was observed in any group. Corticosteroids were efficacious in the beagle model as intracanal medicaments for promoting favorable postavulsion periodontal healing.

The purpose of this study was to assess the healing of periapical tissues using three different materials (IRM [L.D. Caulk Inc, Dentsply International Inc, Milford, DE], Geristore [Den-Mat, Santa Maria, CA], and MTA [ProRoot MTA; Dentsply Tulsa Dental Specialties, Tulsa, OK]) after endodontic microsurgery in an animal model. Using beagle dogs as a study model, 48 bicuspids were accessed, instrumented, and intentionally infected. The surgical procedures were performed after 30 days following the radiographic confirmation of periapical radiolucencies. The root canals were still infected and had no disinfection procedure carried out. The root ends were resected, retrograde preparations were completed, and the experimental materials were placed under surgical operating microscopy. After a period of 6 months, digital radiographic images of the periradicular areas were taken. The samples were prepared for histologic evaluation. Although Geristore showed no radiographic difference when compared with the other groups, it showed the least favorable healing in the histologic evaluation. Our histologic and radiographic results showed no statistical difference between MTA and IRM.

This prospective clinical study showed that the effectiveness of using CBCT to locate additional MB2 canals in maxillary molars appears limited. The use of the dental operating microscope in conjunction with selective troughing and CBCT imaging allowed clinicians to locate 90% (maxillary first molars) and 73% (maxillary second molars) of MB2 canals.