Evaluation of Bony Defect Healing in Apicoectomised Teeth using Sticky Bone, Platelet-rich Fibrin and Guided Tissue Regeneration Membranes: A Randomised Clinical Trial

Introduction: Periapical lesions resulting from endodontic infections pose challenges due to their inflammatory nature and bone resorption effects. Surgical intervention becomes necessary when conventional treatments fail, aiming to achieve complete wound healing and tissue regeneration. Aim: To compare the efficacy of sticky bone, Platelet-rich Fibrin (PRF) membranes and Guided Tissue Regeneration (GTR) membranes in enhancing healing outcomes following periapical surgeries. Materials and Methods: This prospective, single-centre, randomised clinical trial was conducted in the Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, West Bengal, India from July 2022 to December 2023 to evaluate the efficacy of sticky bone, PRF membranes and GTR membranes in enhancing healing outcomes following periapical surgeries. The study involved 30 patients with periapical lesions, who were randomly assigned to three groups: Group I (sticky bone alone), Group II (sticky bone+GTR membrane) and Group III (sticky bone+PRF membrane). The study received ethical clearance from the Institutional Ethics Committee. Outcome measures included periapical lesion size reduction and bone density increase, assessed via Cone Beam Computed Tomography (CBCT) over a 12-month follow-up period. Data analysis was performed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows (Version 27.0), employing paired t-tests and one-way Analysis of Variance (ANOVA) with post-hoc Tukey’s tests, with a significance level of 5%. Results: Significant reductions in periapical lesion size were observed in all groups: Group I (p=0.002), Group II (p=0.001) and Group III (p<0.001). Similarly, significant increases in bone density were noted in Group I (p<0.001), Group II (p<0.001) and Group III (p<0.001). Post-hoc analysis revealed superior outcomes in Group III compared to Group I for both parameters. Conclusion: The PRF membranes demonstrated superior healing kinetics and bone regeneration compared to sticky bone alone. These findings underscore the potential of PRF membranes in enhancing surgical endodontic outcomes. Future multicentre studies with longer follow-up periods are warranted to corroborate these results and refine treatment protocols.