Management of large preiapical lesion with the combination of second generation platelet extract and hydroxyapatite bone graft: a report of three cases.

The pulp tissue necrosis and extensive periodontal diseases leads to the development of the inflammatory periapical lesion which causes a local response of bone around the apex of the tooth. Depends upon the nature of wound and available biological growth factors the outcome will be either regeneration or repair. Being a rich source of growth factors, platelet rich fibrin (PRF) posses many advantages in bone regeneration. The purpose of this case report is to present an attempt to evaluate the healing potential of the combination of PRF and Hydroxyapatite bone graft as opposed to using these materials alone. A periapical endodontic surgery was performed on three patients with a large periapical inflammatory lesion and a large bony defect. The defect was then filled with a combination of PRF and Hydroxyapatite bone graft crystals. Clinical examination exhibited uneventful wound healing. The HA crystals have been replaced by new bone radiographically at the end of two years in Case 1 and Case 2, Case 3 were followed upto one year. On the basis of our cases outcome, we conclude the use of PRF in combination with HA crystals might have accelerate the bone regeneration.