Cirurgia Parendodôntica Associada à Regeneração Tecidual Guiada: Relato de Caso

Abstract

It is known that Endodontics is one of the specialties in Dentistry that has evolved a lot in terms of treatment and materials in recent years. However, there are still cases of failure of conventional endodontic treatment, being associated with several risk factors, the main one being the presence of microorganisms in the apical delta. In these cases, there is still an alternative treatment, which has high success rates, since well indicated, which is the parendodontic surgery. For diagnosis and planning, performing a previous tomographic examination is essential, resulting in a conservative surgery, with less operative time and complexity and with greater chances of success. This study aimed to report a clinical case of parendodontic surgery in association with guided tissue regeneration (GTR), in search of the success of endodontic treatment for the patient, the dentist and the dental element, after 2 failures. The treatment modality recommended in this work was the apicectomy of 3mm, at 90º, using piezoelectric ultrasound, but without the back preparation and retrobturation because the tomographic examination showed an endodontic treatment that was satisfactory thus preserving remaining dentin tissue. As there was extensive bone loss, but a good regenerative predictability by the number of bone walls, xenogenous bone graft was used together with bovine pericardium membrane, enhanced by platelet aggregates. Histopathological examination revealed the presence of a periapical granuloma. Postoperative control was followed for 2 years, resulting in satisfactory bone and tissue regeneration, but not complete due to the presence of premature contact that was subsequently adjusted. It is concluded that parendodontic surgery offers the possibility of permanence of the dental element in the oral cavity after endodontic failures, if it is well indicated.