Salvage Through Endodontic and Periodontal Management – A Bold ACT.

Periapical surgery is an important treatment alternative in the presence of a large periapical cyst. To achieve regeneration and optimal healing of the bone different bone substitutes can be used. A 25 year old male patient reported with the chief complaint of mobile teeth in maxillary anterior tooth region  with 21 labially placed. He had a history of trauma 5 years back. The clinical and radiographic diagnosis of infected periapical cyst with 21,22; Endodontic treatment was performed with 21, 22 followed by periapical curettage. Platelet rich fibrin (PRF) was mixed with Metronidazole gel and used as a regenerative biomaterial in the periapical defect. 6 months follow up shows satisfactory healing and regeneration of periapical region.  There is considerable clinical interest in using PRF in combination with Metronidazole Gel. In conclusion, the results of the present study indicate that metronidazole gel  along with PRF has a beneficial effect on healing of periapical defects. Keywords: Growth factor, Platelet rich fibrin, Regeneration.