 |
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2026, vol. 32, issue2
Subject Area: Dental Medicine
-
DOI: 10.5272/jimab.2026322.6872
Published online: 02 June 2026
Case report
J of IMAB. 2026 Apr-Jun;32(2):6872-6877
THE IMPACT OF COLLAGEN BIOMATERIALS ON BONE HEALING AFTER APICOECTOMY – A CASE REPORT
Madlen Ali1
, Georgi Papanchev1, Tsvetelina Borisova-Papancheva2, Elitsa Dzhongova1,
1) Department of Oral Surgery, Faculty of Dental Medicine, Medical University -Varna, Bulgaria.
2) Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Medical University of Varna, Bulgaria.
ABSTRACT:
Apical surgery involves the surgical treatment of a tooth affected by a periapical or periradicular lesion that cannot be addressed through standard orthograde endodontic therapy. It is typically regarded as a final option for preserving the tooth when conventional retreatment poses considerable therapeutic risks.
This report presents a clinical case involving the surgical treatment of a periapical lesion (diffuse periapical periodontitis) affecting a maxillary left lateral incisor and canine, following failed primary endodontic therapy. A collagen-based product was utilized to enhance bone regeneration.
Follow-up at eight months postoperatively revealed substantial healing, as evidenced by radiographic imaging and clinical examination. The case highlights the potential of collagen biomaterials to function not only as hemostatic agents but also as scaffolds that improve the conditions for new bone formation in large osseous defects.
Keywords: apicoectomy, periapical surgery, collagen biomaterials, bone regeneration, endodontic surgery,
- Download FULL TEXT /PDF 2945 KB/
Please cite this article as: Ali M, Papanchev G, Borisova-Papancheva T, Dzhongova E. The impact of collagen biomaterials on bone healing after apicoectomy – a case report. J of IMAB. 2026 Apr-Jun;32(2):6872-6877. [Crossref - 10.5272/jimab.2026322.6872]
Correspondence to: Madlen Ali, Department of Oral Surgery, Faculty of Dental Medicine, Medical University –Varna; 84, Tsar Osvoboditel Blvd., 9002 Varna, Bulgaria. E-mail: madlen.ali@mu-varna.bg
REFERENCES:
1. 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. [PubMed ]
2. Chattopadhyay S, Raines RT. Collagen-based biomaterials for wound healing. Biopolymers. 2014 Aug;101(8):821-833. [Crossref]
3. Rezvani Ghomi E, Nourbakhsh N, Akbari Kenari M, Zare M, Ramakrishna S. Collagen-based biomaterials for biomedical applications. J Biomed Mater Res B Appl Biomater. 2021 Dec;109(12):1986-1999. [PubMed]
4. Cherim M, Mustafa A, Cadar E, Lupașcu N, Paris S, Sirbu R. Collagen sources and areas of use. Eur J Med Nat Sci. 2019 Oct 15;2(2):8-13. [Crossref]
5. Xu H, Liu Y, Qiu L, Mangue AL, Zhang J, Wei B, et al. Preparation and application of collagen-based hemostatic materials: a review. Collagen&Leather. 2025 Mar;7(1):11. [Crossref]
6. Ferreira AM, Gentile P, Chiono V, Ciardelli G. Collagen for bone tissue regeneration. Acta Biomater. 2012 Sep;8(9):3191-3200. [PubMed]
7. Zirk M, Fienitz T, Edel R, Kreppel M, Dreiseidler T, Rothamel D. Prevention of postoperative bleeding in hemostatic compromised patients using native porcine collagen fleeces: retrospective study of a consecutive case series. Oral Maxillofac Surg. 2016 Sep;20(3):249-254. [PubMed]
8. Borisova-Papancheva T, Svetlozazrova S, Vasileva V. Comparative characteristics of some sealer types used in root canal obturation. Varna Med Forum, 2022, 11, 179–185. [Crossref]
9. Zaneva-Hristova D, Borisova-Papancheva T. [Bioceramics in endodontics—advantages and disadvantages.] [in Bulgarian] Journal of the Union of Scientists - Varna. Medicine and Ecology Series. 2019; 23(1):141-146. [Crossref]
10. Montero-Miralles P, Ibáñez-Barranco R, Cabanillas-Balsera D, Areal-Quecuty V, Sánchez-Domínguez B, Martín-González J, et al. Biomaterials in periapical regeneration after microsurgical endodontics: a narrative review. J Clin Exp Dent. 2021 Sep 1;13(9):e935-e940. [PubMed]
11. von Arx T, Hänni S, Jensen SS. Correlation of bone defect dimensions with healing outcome one year after apical surgery. J Endod. 2007 Sep;33(9):1044-8. [PubMed]
12. Rud J, Andreasen JO, Jensen JEM. Radiographic criteria for the assessment of healing after endodontic surgery. Int J Oral Surg. 1972;1(5):195-214.
13. Molven O, Halse A, Grung B. Observer strategy and the radiographic classification of healing after endodontic surgery. Int J Oral Maxillofac Surg. 1987;16(4):432-439.
14. Wang N, Knight K, Dao T, Friedman S. Treatment outcome in endodontics: the Toronto study—phases I and II: apical surgery. J Endod. 2004;30(11):751-761.
15. Albagle A, Kohli MR, Kratchman SI, Lee SM, Karabucak B. Periapical healing following endodontic microsurgery with collagen-based bone-filling material: a randomized controlled clinical trial. Int Endod J. 2023 Sep 11;56(12):1446-1458. [Crossref]
16. Verma J, Ahuja V. Apicoectomy – A review. J Dent Panacea. 2021;3(1):15-19. [Crossref]
17. Halse A, Molven O, Grung B. Follow-up after periapical surgery: the value of the one-year control. Endod Dent Traumatol. 1991;7(6):246-250.
18. D’Amico E, Pierfelice TV, Lepore S, Iezzi G, D’Arcangelo C, Piattelli A, et al. Hemostatic collagen sponge with high porosity promotes the proliferation and adhesion of fibroblasts and osteoblasts. Int J Mol Sci. 2023;24(9):7749. [Crossref]
Received: 14 October 2025
Published online: 02 June 2026