Multi-modular bone healing assessment in a randomized controlled clinical trial of root-end surgery with the use of leukocyte- and platelet-rich fibrin and an occlusive membrane

Meschi, Nastaran; Vanhoenacker, Anke; Strijbos, Olaf; Santos, Bernardo Camargo Dos; Rubbers, Eléonore; Peeters, V.; Curvers, Frederik; Mierlo, Maarten Van; Geukens, Arne; Fieuws, Steffen; Verbeken, Eric; Lambrechts, Paul

doi:10.1007/s00784-020-03309-1

Cited by 12 publications

(21 citation statements)

References 49 publications

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“…All the studies were clinical, and the maximum follow-up duration was 1 year. 1 3 10 17 18 19 The studies conducted periapical surgery irrespective of the material used.…”

Section: Resultsmentioning

confidence: 99%

“…Studies applied the criteria of Rud et al (1972) 8 and Molven et al (1987) 9 to classify outcomes into 1) complete healing, 2) incomplete healing, 3) uncertain healing, or 4) unsatisfactory healing. 1 3 4 10 17 20 21 The modified Penn 3D criteria were also used to assess 3D healing using CBCT scans. 10 17 21 …”

Section: Resultsmentioning

confidence: 99%

“…The risk-of-bias assessment was done on 10 studies using the Joanna Briggs Institute Critical Appraisal Checklist. Four of these 10 studies were randomized controlled trials, 1 17 18 21 which had a low to moderate risk of bias ( Fig. 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…A peri-radicular infection may persist even after adequate root canal treatment. 1 Normal function, a lack of clinical symptoms, and osseous regeneration signs in radiographs coupled with the re-establishment of a periodontal ligament space are indicators of favourable healing of apical periodontitis. 2 Assessments of periapical surgery are usually based on clinical and radiographic criteria.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of healing assessments of periapical endodontic surgery using conventional radiography and cone-beam computed tomography: A systematic review

et al. 2022

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Purpose This systematic review aimed to compare assessments of the healing of periapical endodontic surgery using conventional radiography and cone-beam computed tomography (CBCT). Materials and Methods This review of clinical studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. All articles published from 1990 to March 2020 pertaining to clinical and radiographic healing assessments after endodontic surgery using conventional radiography and CBCT were included. The question was “healing assessment of endodontic surgery using cone-beam computed tomography.” The review was conducted by manual searching, as well as undertaking a review of electronic literature databases, including PubMed and Scopus. The studies included compared radiographic and CBCT assessments of periapical healing after periapical endodontic surgery. Results The initial search retrieved 372 articles. The titles and abstracts of these articles were read, leading to the selection of 73 articles for full-text analysis. After the eligibility criteria were applied, 11 articles were selected for data extraction and qualitative analysis. The majority of studies found that CBCT enabled better assessments of healing than conventional radiography, suggesting higher efficacy of CBCT for correct diagnosis and treatment planning. A risk of bias assessment was done for 10 studies, which fell into the low to moderate risk categories. Conclusion Three-dimensional radiography provides an overall better assessment of healing, which is imperative for correct diagnosis and treatment planning.

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“…All the studies were clinical, and the maximum follow-up duration was 1 year. 1 3 10 17 18 19 The studies conducted periapical surgery irrespective of the material used.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of healing assessments of periapical endodontic surgery using conventional radiography and cone-beam computed tomography: A systematic review

et al. 2022

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“…2017, Verma 2017, Genena 2019, Garg 2020, Karan & Aricioğlu 2020, Meschi et al . 2020), six had a follow‐up period of less than one year (Del Fabbro et al . 2012, Gupta 2017, Meschi et al .…”

Section: Resultsmentioning

confidence: 99%

Impact of different regenerative techniques and materials on the healing outcome of endodontic surgery: a systematic review and meta‐analysis

2020

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Background Regenerative techniques are increasingly applied in endodontic surgery, but different materials used in regenerative techniques may have varying impacts on wound healing. Objectives This study evaluated the effects of different regenerative techniques and materials on the outcome of endodontic surgery. Participants: patients with persistent periapical lesions, treated with root‐end surgery. Control: endodontic surgery without the use of regenerative techniques/materials. Intervention: endodontic surgery with the use of regenerative techniques/materials. Outcome: combined clinical and radiographic results. Methods PubMed, Web of Science, Embase, SinoMed and the CENTRAL Cochrane were searched up to 10th July 2020, followed by a manual search. Detailed eligibility criteria were applied. Cochrane’s risk‐of‐bias tool 2.0 was used to assess the risk of bias of the eligible studies. Meta‐analysis was conducted using RevMan software. Subgroup analyses were performed based on the regenerative materials used in endodontic surgery. Results Eleven eligible randomized controlled trials (RCTs) were included in the meta‐analysis: two had a low risk of overall bias, and nine had some concerns of overall bias. Generally, the use of regenerative techniques significantly improved the outcome of endodontic surgery (risk ratio [RR]: 0.42; 95% confidence interval [CI], 0.26–0.68; P < 0.001). On subgroup analysis, the use of expanded polytetrafluoroethylene (e‐PTFE) membranes alone had no added benefits (RR: 2.00; 95% CI, 0.22–18.33; P = 0.54). The application of collagen membranes or autologous platelet concentrates (APCs) alone was associated with a trend for better outcomes (RR: 0.51; 95% CI, 0.20–1.25; P = 0.14) (RR: 0.55; 95% CI, 0.18–1.71; P = 0.30). The combined use of collagen membranes and bovine‐derived hydroxyapatite significantly improved the outcome (RR: 0.35; 95% CI, 0.17–0.75; P = 0.007). Discussion This systematic review evaluated the effects of collagen membranes, e‐PTFE membranes, APCs and bone grafting materials, providing detailed information about the risks and benefits of using each regenerative technique/material or its combination in endodontic surgery. Conclusions Regenerative techniques improve periapical lesion healing after endodontic surgery. The combined use of collagen membranes and bovine‐derived hydroxyapatite may be beneficial as an adjunct to endodontic surgery. In contrast, the positive efficacy of e‐PTFE membranes or APCs alone remains doubtful.

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Effect of amniotic membrane and platelet‐rich fibrin membrane on bone healing post endodontic surgery: An ultrasonographic, randomized controlled study

Johri

Verma

Tikku

et al. 2022

J Tissue Eng Regen Med

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The use of membrane barriers and bone grafting materials in endodontic surgery promotes healing by regeneration rather than repair by scar tissue. Due to its valuable regenerative and therapeutic properties, the human amniotic membrane can support ideal periapical rehabilitation and promote better healing after surgery. The current trial aimed to evaluate the amniotic membrane's healing potential and compare it with platelet‐rich fibrin using color doppler sonography. The current study is a randomized, double‐blinded, parallel‐group, single‐center study. Thirty‐four systematically healthy individuals requiring endodontic surgery who fulfilled all inclusion and exclusion criteria were selected and randomly placed in two groups. Surgical curettage of the bony lesion was performed and filled with hydroxyapatite graft. Amniotic membrane (Group 1) and platelet‐rich fibrin (Group 2) were placed over the bony crypt, and the flap was sutured back. The lesion's surface area and vascularity were the parameters assessed with ultrasound and color doppler. and observations: The groups found a significant difference in mean vascularity at 1 month and mean vascularity change from baseline to 1 month (p < 0.05). Mean surface area had no statistically significant difference between the groups. However, in terms of the percentage change in surface area, a significant difference was found from baseline to 6 months (p < 0.05). Amniotic membrane was a significantly better promoter of angiogenesis than platelet‐rich fibrin in the current trial. The osteogenic potential of both materials was similar. However, the clinical application, availability, and cost‐effectiveness of amniotic membrane support it as a promising therapeutic alternative in clinical translation. Further large‐scale trials and histologic studies are warranted.

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Multi-modular bone healing assessment in a randomized controlled clinical trial of root-end surgery with the use of leukocyte- and platelet-rich fibrin and an occlusive membrane

Cited by 12 publications

References 49 publications

Comparison of healing assessments of periapical endodontic surgery using conventional radiography and cone-beam computed tomography: A systematic review

Comparison of healing assessments of periapical endodontic surgery using conventional radiography and cone-beam computed tomography: A systematic review

Impact of different regenerative techniques and materials on the healing outcome of endodontic surgery: a systematic review and meta‐analysis

Effect of amniotic membrane and platelet‐rich fibrin membrane on bone healing post endodontic surgery: An ultrasonographic, randomized controlled study

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