Journal of Periodontology Online - Journal of Periodontology - 78(12):2385

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

Shaul Lin^*^†^‡ and Yaniv Mayer^§

*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.

Correspondence: Dr. Shaul Lin, Endodontics and Dental Trauma Unit, Department of Oral and Dental Medicine, Rambam Medical Center, P.O. Box 9602, Haifa, Israel. Fax: 972-4-8341346; e-mail: linsn@post.tau.ac.il.

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° 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.

KEYWORDS: Dental implants, lesion, root canals