International Journal of Clinical Case Reports 2016, Vol.6, No.22, 1-8
2
blood harvest and shows a complex architecture as a healing matrix including mechanical properties that no other
platelet concentrates offers (Choukroun et al., 2000; Dohan et al., 2006). Also, as an autologous biomaterial, it has
found numerous clinical applications that have been described in length in the literature (Choukroun et al., 2006;
Choukroun et al., 2006; Diss et al., 2008; Mazor et al., 2009; Zhao et al., 2011). Herewith, we are presenting a
case report of a combined endo-perio lesion that was treated successfully by a combination of autologous PRF
with bovine derived xenograft, and that was assessed clinically and radiographically with a 12-month follow-up.
2 Case Report
A 35 year old patient reported to the department with a chief complaint of swelling in the upper front tooth region
since 2 months. The patient had reported trauma in the same region 7 years back. The nature of the pain was
intermittent in nature. The patient used to take analgesics to relieve the pain. The past medical history of the
patient did not reveal any significant finding and the patient was systemically healthy and was not on any
medication. Patient revealed no history of smoking and alcohol and other deleterious habits. On examination,
there was a swelling of about 3cm x 3cm with Ellis class IV fracture in relation to 11. The tooth appeared to be
discolored (Figure 1). The pulp vitality tests revealed that the tooth was non-vital while the radiographic
examination of the concerned area in the form of an intra-oral peri-apical radiograph (IOPAR) revealed that it had
a large peri-apical radiolucency (Figure 2). Periodontal probing revealed a deep periodontal pocket measuring
about 15 mm in depth (Figure 3). The provisional diagnosis arrived-at was a combined endo-perio lesion in
relation to 11 region. Endodontic Therapy: At the initial visit, immediate emergency access opening was done and
the pus was drained-out. The access was kept open and only a thick cotton pledget was used to close the access for
a day. Next day, the patient was recalled and the cotton pledget was removed and the canal was re-irrigated with
saline. The swelling had reduced. Patient was recalled for irrigation and dressing after 4 days till which time, the
swelling had completely resolved. Working length and biomechanical preparation were completed with the tooth
(Figure 4). Calcium hydroxide dressing was given for 7 days and the access was closed with a temporary
restoration (Figure 5). A dressing was given again and the patient was recalled after 7 days for the follow-up and
then, the patient was transferred to Department of Periodontics for opinion and needful. A thorough oral
prophylaxis was done in the concerned region (Figure 6) and the patient was recalled for completion of
endodontic treatment (Figure 7).
Figure 1 Showing discolored, non-vital 11 with Ellis class IV
fracture
Figure 2
Showing IOPAR revealing a large peri-apical
radiolucency
Figure 3
Showing probing depth of around 15 mm as
measured with the help of a periodontal probe
Figure 4
Showing working length determination as seen on
IOPAR
