Periapical scar formation after apicoectomy using leukocyte- and platelet-rich fibrin as sole filling material: a case report with 6-year follow-up.

Apicoectomy is a traditional surgical technique for treating endodontic-periodontal lesions. The use of biomaterials as fillers to improve tissue recovery at the surgical site has been gaining prominence in clinical dental practice, and leukocyte- and platelet-rich fibrin (L-PRF) membranes have demonstrated the potential to achieve effective results in resolving bone defects. This case report describes the use of an apicoectomy and L-PRF membranes on the maxillary left lateral incisor (tooth 10) to treat a persistent periapical lesion that remained after 2 unsuccessful nonsurgical endodontic treatments. When a 53-year-old woman attended a periodontics clinic for scaling and root planing, a radiograph revealed a periapical lesion at tooth 10. The lesion persisted after both nonsurgical root canal therapy and subsequent endodontic retreatment. The patient underwent apicoectomy combined with open flap scaling and root planing as well as placement of L-PRF membranes as a filling material for the bone defect to improve healing of the surgical area. Follow-up examinations were performed at 7 days, 1 month, and 6 years. Mineralization in the area of bone loss and regression of the periapical lesion were reported, favoring tissue stability. In this patient, apicoectomy combined with the use of L-PRF to fill the bone defect led to clinical and radiographic treatment success.