The rationale for the application of bone grafts in periapical surgery: A review

Abstract

Following periapical surgery, restoration of the destroyed bony architecture is a pre-requisite. Previous studies had shown that supplementing with artificial bone substitutes, growth factors or barrier membranes in the osseous defects is essential in influ-encing the healing following surgical intervention. This review is intended to focus on whether tissue regeneration with the aid of bone grafts coupled with a membrane barrier will suffice or is there a need for recruiting progenitor/stem cells. A literature search was conducted on several medical databases. All studies that used bone graft following periapical surgery were included Around 38 relevant articles were selected for this review. Literature shows that the mere use of a membrane barrier and/or bone graft following surgery would not yield the desired outcome. Previous studies show that some substitutes are capable of generating progenitor/stem cells and induce the undifferentiated mesenchymal cells to differentiate. Bone augmentation with the aid of bone graft materials along with biologically active molecules in addition to a mechanical barrier in the form of a membrane would enhance the healing of periapical tissues following periapical surgery. Better bone fill, gain in clinical attachment level is achieved with the use of various grafts as compared to non grafted sites.