PRF Membrane and Recovery After Periapical Surgery: A 3D Imaging Study

Inclusion Criteria:

* Adults aged 20-65 years, both male and female.
* Diagnosed with periapical disease, including periapical cysts or granulomas.
* Requiring periapical surgery as part of their treatment plan.
* Presenting a tooth needing endodontic surgery with periradicular lesions of strictly endodontic origin.
* Size of the bone crypt between 6 mm and 12 mm.
* Non-surgical retreatment considered unfeasible or previously failed.
* Apical root canal free from posts over a length of at least 6 mm.
* Adequate coronal restoration without coronal leakage.
* Willing and able to provide written informed consent.
* Capable of attending follow-up visits and participating in required assessments.
* Maxillary and mandibular teeth limited to the 2nd premolar to 2nd premolar regions.
* Without general medical contraindications for oral surgical procedures.

Exclusion Criteria:

* Patients with systemic conditions affecting healing, such as:

  * • Uncontrolled diabetes mellitus.
  * • Autoimmune disorders.
  * • Chronic inflammatory diseases.
* Pregnant or breastfeeding individuals.
* Use of medications or therapies that may interfere with healing, including:

  * • Bisphosphonates.
  * • Immunosuppressants.
  * • Radiotherapy.
  * • Oncological therapies (e.g., chemotherapy, immunotherapy).
* Requires antibiotic prophylaxis or therapy.
* History of allergies or adverse reactions to blood-derived products.
* Neuropsychiatric disorders.
* Active infection or severe periodontal disease in the surgical area.
* Periodontal probing depths greater than 5 mm.
* Moderate to severe periodontal bone loss.
* Vertical root fractures.
* Perforation of the furcation area or root canal, except for the apical area.
* Smokers or individuals unwilling to refrain from smoking during the study period.
* Participation in another clinical trial within the last 30 days.
* Absolute or relative contraindications for surgery.