Correction of a large periradicular lesion and mucosal defect using combined endodontic and periodontal therapy: a...

The successful treatment of a large endodontically induced periradicular defect and soft tissue fenestration by combined endodontic and periodontal therapy is described. Endodontics was performed on the mandibular left central incisor, the apex was resected, and a retrograde amalgam was placed. The defect was thoroughly debrided and the exposed root surface was planed with curettes. Demineralized freeze-dried bone allograft and a nonresorbable membrane were placed over the defect and the exposed root surface. The membrane was removed in 6 months and there appeared to be bone regeneration with complete closure of the soft tissue fenestration. Endodontic therapy in combination with guided tissue regeneration and bone grafting may provide another modality of treatment for endodontically related hard and soft tissue defects.