Management of Root Fenestration Using Buccal Decortication and Guided Tissue Regeneration: A Case Report and...

Area of Science:

• Dentistry
• Oral Surgery
• Regenerative Medicine

Background:

• Apical fenestration management traditionally involves apical root resection, with limited case studies showing symptom resolution.
• This approach has shown inconsistent results, sometimes leading to persistent symptoms and further bone loss.

Observation:

• A patient with persistent discomfort and bone loss post-apical root resection due to apical fenestration was treated with corrective surgery.
• The corrective procedure incorporated guided bone regeneration and decortication of the cortical plate to stimulate bleeding.

Findings:

• The corrective surgery successfully resolved the patient's clinical symptoms within weeks.
• Follow-up imaging confirmed apical root coverage, and 3D analysis revealed approximately 200 mm³ of bone gain and 2 mm linear bone gain.
• This demonstrates a significant positive outcome compared to the initial treatment.

Implications:

• Guided bone regeneration combined with decortication offers a viable and conservative alternative for managing complex apical fenestration cases.
• This approach can effectively address persistent symptoms and promote substantial bone regeneration without compromising the root apex.
• The findings suggest a potential improvement in treatment protocols for root fenestration, enhancing patient outcomes.