Clinical Outcomes of Apicoectomy in Traumatic Anterior Teeth with 1-year Follow-up - A Case series

This case series evaluates the clinical efficacy of various platelet-rich fibrin (PRF)-based regenerative techniques in managing complex periapical lesions and through-and-through defects. Five patients with large lesions resulting from trauma underwent apicoectomy with mineral trioxide aggregate retrograde filling. Regenerative protocols varied, including synthetic bone graft alone, PRF alone, PRF with synthetic or autogenous bone grafts, and a combination of PRF, graft, and barrier membrane. Clinical and radiographic follow-up at 1 year, based on Rud and Mølven criteria, showed complete healing in cases utilizing PRF, either alone or as an adjunct. Conversely, the case using only synthetic bone graft demonstrated incomplete healing, likely due to slower remodeling. PRF’s success is attributed to its ability to stimulate angiogenesis and provide sustained growth factor release. While limited by sample size, these results suggest that a multimodal approach incorporating PRF offers a predictable, cost-effective, and biologically superior surgical strategy for enhancing bone regeneration in extensive periapical defects.