The use of calcium sulphate in the surgical treatment of a 'through and through' periradicular lesion

Aim This randomized, controlled, clinical study was designed to evaluate th e adjunctive effect of calcium sulphate grafts on the surgical treatment of through and through periradicular lesions. Methodology Twenty patients each with one tooth showing evidence radiologic ally of a periradicular lesion wider than 10 mm, with lack of both buccal a nd lingual cortical bony plates and an indication for surgery were selected for the study. Ten teeth were treated with apicectomy, root-end filling an d grafting of the bone defect with calcium sulphate prior to suturing (test group), The other 10 teeth received the same surgical therapy but no graft ing with calcium sulphate (control group). The outcome of the healing proce ss was evaluated at 6 and 12 months radiographically following the criteria reported by Rud and Andreasen. Results At the six- and 12-month evaluation the test group had seven teeth with complete healing and two with incomplete healing, whilst the control g roup showed three teeth with complete healing, five with incomplete healing and one with unsatisfactory healing. One tooth in each group had to be ext racted because of a vertical fracture that occurred during the follow-up pe riod, Conclusions The results of the study demonstrate that the addition of calci um sulphate as a bone graft during the conventional surgical treatment of t hrough and through lesions improves the clinical outcome, Histological anal ysis is desirable to investigate the quality of tissues formed using the tw o surgical procedures.