Kaula reģenerācijas noteikšana pēc apikālās ķirurģijas, lietojot ar trombocītiem bagātināto fibrīnu

Healing of periapical lesions and subsequent bone regeneration following surgical intervention are key determinants of long-term treatment prognosis and functional outcomes. Delayed or incomplete healing may compromise bone quality and stability, potentially complicating future implant placement and the achievement of functional and aesthetic prosthetic rehabilitation. The doctoral thesis, entitled “Evaluation of the Impact of Platelet-Rich Fibrin on Bone Regeneration Following Apical Surgery,” investigates the effect of Advanced Platelet-Rich Fibrin (A-PRF) on bone healing after apical surgery and evaluates the diagnostic performance of different imaging modalities used for the assessment of periapical lesions. Apical surgery is indicated for persistent periapical lesions when conventional endodontic treatment has failed; therefore, effective diagnostic methods and regenerative approaches are essential for optimizing surgical outcomes and postoperative healing. Two complementary studies were conducted involving 43 adult patients who underwent apical surgery at the Institute of Stomatology, Rīga Stradiņš University. The first study was conducted to compare the diagnostic accuracy of periapical radiography (PA), cone-beam computed tomography (CBCT), and ultrasonography (US) in the detection of periapical lesions. The second study, designed as a randomized controlled trial, focused on the radiological evaluation of the effect of A-PRF on postoperative bone regeneration. Healing outcomes were assessed using quantitative CBCT-based volumetric measurements of periapical lesion changes, as well as standardized two-dimensional and three-dimensional radiological healing criteria. Imaging was performed preoperatively and at 6 and 12 months postoperatively. The results demonstrated that CBCT provides the highest diagnostic accuracy and the most detailed assessment of periapical lesion morphology and volume. Ultrasonography, while exhibiting lower diagnostic accuracy, was nevertheless capable of identifying lesion presence and estimating lesion size and may therefore serve as a complementary imaging modality in selected clinical scenarios. Given the high success rate of apical surgery and the consistently favourable healing dynamics observed irrespective of A-PRF application, no statistically significant additional radiological effect of A-PRF on bone regeneration could be demonstrated in this study. However, this finding does not exclude the biological activity of A-PRF or its potential contribution to healing processes that may not be fully captured by radiological outcome measures. The thesis presents the study through an introduction outlining the research framework, followed by a review of the literature, materials and methods, the obtained results and their interpretation in the discussion, and concludes with the main findings and clinical implications.