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Interdisciplinary management of large Periapical lesion with endodontic origin – a short review

Rajakeerthi R., Nivedhitha M.S.


Periapical wound recuperating is an unpredictable and dynamic procedure of supplanting devitalised and missing cell structures and tissue layers. The way toward mending includes regenerative and repair stages. The regeneration is when healing takes place by proliferation of parenchymal cells, including primary and secondary healing. Whereas repair is when healing takes place by proliferation of connective tissues. The periapical surgery is believed to be the preferred approach in the management of large periapical lesions, which comprise of periapical abscess, radicular cysts, etc. It is well known that the essential three growth factors to achieve tissue healing are platelet derived growth factors, vascular endothelial growth factors, and transforming growth factors. However, the fibrin matrix of PRF gets slowly resorbed, and releases the growth factors such as PDGF, TGF, VEGF maintaining a viable and everlasting field to enhance the healing. The combination of bone graft along with PRF had the potential to enhance the bone formation. In investigation of the tissue regeneration of periapical tissues, these factors have been properly consolidated and applied to the target area to accomplish faster healing of the large periapical lesions.

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