PMC3747416_01
Preoperative view of the lesion.
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fig1
A draining fistula was seen on the labial aspect in relation to 41 (Figure 1). 42 had grade I mobility, whereas no mobility was noticed with 31, 41, and 43.
Preoperative radiograph.
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fig2
On radiographic examination, two radiolucent areas of size approximately 2 x 2 mm were seen in relation to 41, 42, and 43 (Figure 2).
Debridement of the lesions.
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fig3
Fragmented pieces of the lesion were freed from the bone, and complete curettage of the cystic lesions was done (Figure 3).
DFDBA graft placement.
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fig4
DFDBA was mixed with sterile saline solution and grafted in an attempt to close the defect via osteoconduction (Figure 4).
Harvested autologous periosteum.
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fig5
Autologous healthy periosteum was harvested from the 31-32 region (Figure 5), and PRF was prepared from the patient's blood, as described by Choukroun et al..
Autologous periosteum placed as a barrier membrane.
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The lesion was covered with periosteum, over which PRF was placed as a second layer of barrier membrane covering the graft (Figures 6 and 7).
PRF placed as a barrier membrane.
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fig7
The lesion was covered with periosteum, over which PRF was placed as a second layer of barrier membrane covering the graft (Figures 6 and 7).
Sutured flap with 3-0 silk suture.
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fig8
The flap was coronally advanced and closed with interrupted sutures using 3-0 black braided silk (Figure 8).
Histopathology of excised cyst.
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fig9
Connective tissue showed dense infiltration of lymphocytes and plasma cells with few macrophages (Figure 9).
6 months postoperative radiograph.
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Radiograph at 6 months shows a healing lesion (Figure 10).
9 months postoperative radiograph.
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fig11
A subsequent radiograph 9 months after operation (Figure 11) reveals increased radiopacity where the bone graft was placed, and no evidence of recurrence of the lesion was seen (Figure 12).
Healing at 9 months after operation.
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fig12
A subsequent radiograph 9 months after operation (Figure 11) reveals increased radiopacity where the bone graft was placed, and no evidence of recurrence of the lesion was seen (Figure 12).