Date of Award

Fall 6-23-2021

Degree Type


Degree Name

MSOB (Master of Science in Oral Biology)

Primary Advisor

Dr. Bekir Karabucak


Introduction: The purpose of this randomized controlled clinical trial was to evaluate two dimensionally and 3-dimensionally the effect of resorbable collagen-based bone filling material on periapical healing following endodontic microsurgery (EMS) on endodontic lesions presenting four-wall defect.

Methods: Thirty-nine cases with lesions of strictly endodontic origin and four-wall defect morphology underwent EMS and were randomly assigned to the treatment or control group. In the treatment group, a collagen-based bone filling augmentation material (Foundation, J. Morita USA) was placed into the osteotomy site after root resection, root-end filling, and induced bleeding. In the control group, the flap was repositioned after induced bleeding in the osteotomy with no material added. Clinical, PA, and CBCT examinations were completed after 12 months. Healing was evaluated using PA radiographs according to Molven’s criteria and CBCT using PENN 3D criteria. Cortical plate healing was scored according to Chen’s et al. and RAC/B index.

Results: Thirty-two cases were evaluated at the 12 months follow up consisting of 14 cases in the control group and 18 in the treatment group. A total of 11 cases in the control and 17 cases in the treatment group demonstrated complete healing on PA radiographs. On CBCT, 5 and 12 of cases had completely healed in the control and treatment groups, respectively. Finally, 13 cases in the treatment and 6 cases in the control group had reestablished cortical plate. However, none of the results were statistically significant.

Conclusion: Within the limitation of the present study, the use of collagen-based bone filling augmentation material did not show statistical significance in improving periapical healing when used as a coadjutant approach for endodontic lesions with the four-wall defect. Larger-scale studies are needed to provide more conclusive results.

Included in

Dentistry Commons