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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
Summary
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.
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.
