A Comparative study of the use of guided tissue regeneration and allogenic bone grafts in the treatment of apical resection cases with computed tomography

Recently membranes for guided tissue regeneration (GTR) and bone grafts are commonly used in oral and maxillofacial surgery for favoring the proliferation of bone tissue. Also there are some clinical, radiological and histopathological studies about the effects of these materials in apical resections. In this study resorbable glycolide / lactide membranes and solvent dehydrated bone grafts have been used in apical resection cavities. Short and long term evaluations were examined by low-dose Computed Tomography (CT) and Dentascan Software Program. For this aim 40 defects were used. In the first group (n=10), membranes (Resolut - Regenerative Material, Gore Regenerative Materials USA) were applied for guided tissue regeneration, in the second group (n= 10), bone grafts (Tutoplast Spongiosa Microchips, Biodynamics International GmbH. Erlangen - Tennelohe, Germany) were used. Lesions were grafted and covered with membranes in the third group (n=10), and no membrane or bone graft was used in the control group (n=10). Results were evaluated in short term, 3 and 6 months postoperatively. Periapical radiographs were also taken in these periods. Healing periods were evaluated by measuring the three dimensional sizes of the defects for membrane and control groups and evaluation of the-88- graft density for graft and graft covered with membrane groups by CT and Dentascan Software Program. No significant differences were observed when membrane treatment group was compared with control group (p> 0.05). In the defects that were filled with solvent dehydrated bone grafts, healing process was rapid, superior and remarkable for stabilization and obturation of the cavity when compared with membrane and control groups. But no additional healing formation was determined in the graft covered with membrane group. In short term tomographic evaluations, the first healing symptoms were identified on 7. week. In present study, CT was superior to periapical radiography technique in the evaluation of different treatment methods of periapical lesions because of the three dimensional features. In addition, low-dose CT application was used to prevent the patients from the negative effects of the radiation, so the total radiation dose was not reached the classical CT dose in all evaluation periods, is the other advantage of the procedure. When compare with plain radiographs, CT has many advantages and must be frequently used in oral and maxillofacial surgery.