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Endodontic Re-Surgery With Simultaneous Recession Coverage Using a Modified Flap Design After Failed Primary

Sohar Flisfisch1,2, Edgar Schäfer3, Sebastian Bürklein3

  • 1Private Practice Basel Switzerland.

Clinical Case Reports
|October 10, 2025
PubMed
Summary
This summary is machine-generated.

This case report details a new coronally advanced flap technique for apicoectomy, successfully achieving gingival margin repositioning. Biodentine facilitated complete bone healing without bone grafts, showcasing its regenerative potential in endodontic surgery.

Keywords:
apicoectomybone substitutecalcium silicate cementsurgical technique

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Area of Science:

  • Endodontic surgery
  • Regenerative endodontics
  • Periodontal plastic surgery

Background:

  • Apicoectomy is a surgical procedure to treat persistent periapical inflammation.
  • Gingival margin recession can be a complication following apicoectomy.
  • Biodentine is a calcium-silicate based material used in endodontics.

Purpose of the Study:

  • To present a case report on a novel modified coronally advanced flap for apicoectomy.
  • To evaluate the efficacy of Biodentine in achieving bony healing post-apicoectomy.
  • To assess the impact of the surgical technique on gingival margin position.

Main Methods:

  • A modified coronally advanced flap technique was employed during apicoectomy.
  • Biodentine was used as the root-end filling material.
  • Clinical and radiographic assessments were performed to evaluate healing and gingival margin position.

Main Results:

  • The modified coronally advanced flap resulted in a coronal shift of the gingival margin.
  • Complete bony healing was observed radiographically.
  • No bone substitutes were required for the observed bone regeneration.

Conclusions:

  • The described modified coronally advanced flap technique is effective in managing gingival margin position after apicoectomy.
  • Biodentine promotes complete bony healing without the need for bone grafts in apicoectomy procedures.
  • This case highlights a combined surgical and regenerative approach for successful endodontic treatment outcomes.