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Pre-surgical radiograph representing the root canal treatmentin the effected teeth.
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AH plus sealer (Dentsply DeTreyGmbH,Philadelphia, USA) prior to the surgery. A radiograph was taken to assess the root canal treatment (Fig. 1).
Intra-operative picture of the lesion curetted and root end resection completed.
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Following the reflection of the full-thickness mucoperiosteal flap, a bony window was created through the cortical bone (Fig. 2).
Bio-Gen mix  bone graft material.
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A xenograft bone graft material (derived from Horse femur bone) Bio-GenMix  (Bioteck Company, Italy) consisting of a mix of cancellous and cortical bone particles was used (Fig. 3).
Three layers obtained after the centrifugation process with PRF in the middle.
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The PRF clot that was obtained after the processing was retained, whereas platelet-poor plasma (PPP) and the exudates with RBCs were discarded (Fig. 4).
Composite graft prepared with mixture of PRF and Bio-gen mix.
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The bone graft material was mixed with freshly prepared PRF to mold it into a composite graft (Fig. 5).
Amnion membrane applied over the defect area.
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After the defects were grafted, the area was covered with an amnion membrane to act as a mechanical barrier (Fig. 6).
Post-operative radiographic image depicting periapical bone healing after 3 months.
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Radiographs taken after a six-monthfollow-up revealed adequate bone healing in the periapical region. (Fig. 7).
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Pre-surgical radiograph revealing over obturated root canals of the effected teeth.
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Radiographic examination revealed the presence of periapical radiolucency with respect to the apices of 11 and 12 (Fig. 8).
Intra-operative picture of the lesion curetted and root end resection completed.
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The regenerative protocol adopted for case 1 was followed in this case too (Figs. 9-11 ).
Placement of PRF mixed with Bio-Gen mix  into the defect.
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The regenerative protocol adopted for case 1 was followed in this case too (Figs. 9-11 ).
Amnion membrane is placed over the defect site to enhance wound healing.
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The regenerative protocol adopted for case 1 was followed in this case too (Figs. 9-11 ).
Post-operative radiograph image depicting periapical bone healingafter 3 months.
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The patient was recalled every month and a final recall after 6 months revealed sufficient bone healingin the periapical area of both the teeth as observed by a radiographic examination (Fig. 12).