APEC 2021


Jean Philippe Mallet

Minimal Invasive Endo-Surgery with Cortical Bone Window and PRF


Endodontic Microsurgery may be a solution to remove an apical lesion and treat the endodontic cause of the infection, especially if the lesion is a cyst or if the retreatment too destructive for a good prognosis. Introduction of CBCT analysis allow a pre-study to analyze the surgical approach of the lesion.

On lower molars, the access must be difficult or very invasive with a thick mandibular bone (external oblique line). On upper molars the sinus apical projection may make the access more complex .

The “Cortical Bone Window” approach can be the minimally invasive solution. Thus, the visibility and the access of the lesion for the root preparation and filling would be more predictable.

To be released, the quadrilateral piece of cortical bone can be cut with piezo inserts in order to be more precise, less invasive and safe with the non-body anatomical structures. The PRF preparations (clots and membranes) allow a better bone healing and an easier stable re-seating of the window. 

On molars endodontic surgery, the “Cortical Bone Window” technique may allow the operator an easier surgery and a quicker healing with a high regenerative healing potential

Key learning point

By the end of this presentation attendees will be able to:

- Analyze the indication of the "Cortical Bone Window" technique on molars endo- surgery.

- Describe the surgical approach of the "Cortical Bone Window" technique

- Give benefits of the "Cortical Bone Window" technique added to a PRF preparation.

Short cv

Dental practice limited to Endodontics in Paris (France)

Graduated from the University Paris V – René Descartes (Paris, France).

At present: Teaching Associate at the University Paul Sabatier (Toulouse, France).

Past Assistant Professor at University Paris V.

Member of the editorial board of ENDO (Quintessence)

Past President of the French Society of Endodontics

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