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Journal of Oral Science & Rehabilitation 40 Volume 2 | Issue 2/2016 B o n e b l o c k g r a f t t o t r e a t a p i c o m a r g i n a l d e f e c t 1. Dietrich T, Zunker P, Dietrich D, Bernimoulin JP. Apicomarginal defects in periradicular surgery: classification and diagnostic aspects. → Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Aug;94(2):233–9. 2. Hirsch JM, Ahlström U, Henrikson PA, Heyden G, Peterson, LE. Periapical surgery. → Clin Implant Dent Relat Res. 1979 Jun;8(3):173–85. 3. Skoglund A, Persson G. A follow-up study of apicoectomized teeth with total loss of the buccal bone plate. → Oral Surg Oral Med Oral Pathol. 1985 Jan;59(1):78–81. 4. Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. → J Endod. 2006 Jul;32(7):601–23. 5. Kim E, Song JS, Jung IY, Lee SJ, Kim S. Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal-endodontic origin. → J Endod. 2008 May;34(5):546–51. 6. Rankow HJ, Krasner PR. Endodontic applications of guided tissue regeneration in endodontic surgery. → J Endod. 1996 Jan;22(1):34–43. 7. Douthitt JC, Gutmann JL, Witherspoon DE. Histologic assessment of healing after the use of a bioresorbable membrane in the management of buccal bone loss concomitant with periradicular surgery. → J Endod. 2001 Jun;27(6):404–10. 8. Britain SK, von Arx T, Schenk RK, Buser D, Nummikoski P, Cochran DL. The use of guided tissue regeneration principles in endodontic surgery for induced chronic periodontic-endodontic lesions: a clinical, radiographic, and histologic evaluation. → J Periodontol. 2005 Mar;76(3):450–60. 9. 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Efficacy of guided tissue regeneration in the management of through-and-through lesions following surgical endodontics: a preliminary study. → Int J Periodontics Restorative Dent. 2008 Jun;28(3):265–71. 14. Pecora G, De Leonardis D, Ibrahim N, Bovi M, Cornelini R. The use of calcium sulphate in the surgical treatment of a ‘through and through’ periradicular lesion. → Int Endod J. 2001 Apr;34(3):189–97. 15. Tsesis I, Rosen E, Tamse A, Taschieri S, Del Fabbro M. Effect of guided tissue regeneration on the outcome of surgical endodontic treatment: a systematic review and meta-analysis. → J Endod. 2011 Aug;37(8):1039–45. 16. Von Arx T, AlSaeed M. The use of regenerative techniques in apical surgery: a literature review. → Saudi Dent J. 2011 Jul;23(3):113–27. 17. Dietrich T, Zunker P, Dietrich D, Bernimoul in JP. Periapical and periodontal healing after osseous grafting and guided tissue regeneration treatment of apicomarginal defects in periradicular surgery: results after 12 months. → Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Apr;95(4):474–82. 18. Goyal B, Tewari S, Duhan J, Sehgal PK. Comparative evaluation of platelet-rich plasma and guided tissue regeneration membrane in the healing of apicomarginal defects: a clinical study. → J Endod. 2011 Jun;37(6):773–80. 19. Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomized clinical trial. → Clin Oral Implants Res. 2010 Dec;21(12):1394–403. 20. De Carvalho PS, Vasconcellos LW, Pi J. Influence of bed preparation on the incorporation of autogenous bone grafts: a study in dogs. → Int J Oral Maxillofac Implants. 2000 Jul-Aug;15(4):565–70. 21. Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: a clinical study with 40 partially edentulous patients. → J Oral Maxillofac Surg. 1996 Apr;54(4):420–32. References defects.18 They conducted a study with three groups: In the first group, the defect was cover- ed with a collagen membrane (n = 10); in the secondgroup,aPRPpreparationwasplacedover the defect (n =10); and inthe last group, PRPwas packedintothedefectandacollagenspongewas usedto coverit (n = 10).The overallrate ofhealed cases was 80.76%, with differences that were not statistically significant between the groups. Currently,theuseofultrasound,amplification andmagnificationdeviceshasimprovedtheprog- nosis of periapical surgery.4 In this case report, these advances allowed treatment of an apico- marginal defect with a bone block graft after pe- riapical surgery of two maxillary incisors. There arenostudiesintheliteratureontheuseofablock graft to treat this type of lesion simultaneously with apical surgery. Bone block grafts are used in implantologyowingtoosteogenic,osteoinductive and osteoconductive potential. Thus, although there are currently very few studies that provide scientificevidencesufficienttodeterminetheideal treatment of apicomarginal defects, we believe that the procedure proposed in this article can be an alternative for the treatment of these defects. One of the main problems with this type of graft is management of the soft tissue, since in order to minimize the risk of dehiscence, it is necessary to achieve a tension-less wound clo- sure.19 The stabilization and intimate contact between the block graft and the recipient bed have been considered crucialto a successfulout- come.20 This can be achieved with the use of osteosynthesis screws.21 Conclusion The use of a bone block graft to treat an apico- marginaldefectinconjunctionwithapicalsurgery achieved complete healing of the periradicular tissue in this case. Competinginterests The authorsdeclarethattheyhave nocompeting interests.