Interdisciplinary approach for treating a large through-and-through periapical defect using guided tissue regeneration: a case report.

A number of diagnostic and management challenges exist for achieving complete regeneration of large through-and-through periapical lesions. An unfavorable endodontic outcome may occur as a result of uncontrolled infection or unpredictable bone healing. This article presents a case with a 15 x 15-mm through-and-through periapical lesion and persistent gingival swelling. Endodontic microsurgery and guided tissue regeneration were performed using a resorbable membrane and osseous substitute. A 2-year postoperative radiograph revealed complete resolution of the periapical radiolucency. Seven-year clinical and radiographic follow-up showed that the tooth was asymptomatic and a long-term successful outcome had been maintained.