Grafting Endodontic Lesions
Day of apical surgery. Clinically, a buccal fistula was present with a bony dehiscence of approximately 10mm. Granulation tissue was removed with minor instrumentation of apex of the tooth. The apical lesion was grafted with Socket Graft Plus without a membrane.
Successful treatment, 1.5 year post op.
Dr. Ruefenacht made the assumption that because the tooth had been endodontically treated twice, it was likely that the tooth was successfully obturated and that the apical lesion was now a primary lesion. In other words, the tooth was no longer infected, but the apical bony lesion was now the infection, and this was the reason why the lesion did not resolve. If that was the case, then by removing the granulation tissue and grafting with a material that is structurally designed to resist colonization, the lesion should then heal. The healing of this lesion with minimal alteration of the tooth supports his assumption.
For a more detailed discussion of this case, Dr. Ruefenacht can be reached at:
Innovative Dental Solutions
3509 School St
Lafayette, CA 94549