Radicular Cysts: When Platelet-Rich Plasma Becomes a Game Changer

Bone healing post-cystectomy: the contribution of the synthetic bone and PRP combo

The management of residual cavities after the enucleation of radicular cysts constitutes a daily challenge in oral surgery, where the predictability of bone regeneration is crucial. This cross-sectional descriptive study, conducted on a cohort of 30 patients within the Central Hospital of Odonto-Stomatology (Vietnam), analyses a therapeutic strategy combining synthetic bone and Platelet-Rich Plasma (PRP). The objective is to rigorously evaluate the clinical and radiographic healing process following apical resection and filling of the lesion.

The authors tested the hypothesis that the integration of PRP would optimize soft tissue closure and bone substitute stabilization, thereby reducing the classic complications of this type of surgery. The research protocol focused on longitudinal follow-up at 1 week, 1 month, and 3 months postoperatively, specifically measuring wound evolution, infection rate, and the degree of bone gap filling. For the practitioner, this study aims to confirm whether this regenerative approach achieves stable primary healing and a sufficient bone success rate to consider long-term rehabilitation.

Study methodology: Evaluation of the combination of synthetic bone and PRP

This cross-sectional descriptive study was conducted within the department of maxillofacial surgery at the National Hospital of Odonto-Stomatology. The objective was to evaluate healing kinetics and bone regeneration following the surgical treatment of radicular cysts.

The protocol was structured around the following key points:

• Population: The sample included 30 patients who underwent radicular cyst enucleation.
• Surgical protocol: After excision of the lesion, the bone defect was filled with a graft combining synthetic bone and platelet-rich plasma (PRP).
• Clinical and radiological follow-up: Patients were reassessed at three specific chronological stages: 1 week, 1 month, and 3 months after the procedure.
• Analyzed variables: The study measured wound characteristics, the presence or absence of postoperative infection, and the level of defect filling by the bone substitute.
• Success criteria: The result was considered "good" if healing was healthy, without infection, with a bone cavity filling rate greater than 40% at the 3-month mark.

Data was collected through direct clinical examination and X-ray imaging to precisely quantify the density of the filling over time.

Results: Healing dynamics and filling kinetics

Analysis of the data collected from the 30 patients followed within the department of oral and maxillofacial surgery reveals a constant progression of clinical and radiographic healing indicators after the enucleation of the radicular cyst and the combined contribution of synthetic bone and PRP.

Clinical healing and absence of infection

Le suivi clinique montre une amélioration significative de l'état des tissus mous au fil des examens. Si 30 % des patients présentaient encore des signes de cicatrisation incomplète ou de réaction inflammatoire à une semaine, la quasi-totalité de la cohorte a atteint une résolution clinique stable à un mois.

Post-operative period	Optimal healing (without infection)	Percentage (%)
1 week	21 / 30	70.0 %
1 month	28 / 30	93.3%
3 months	29 / 30	96.7 %

Radiographic evaluation of bone filling

After 3 months, the radiographic examination allowed for the quantification of the regeneration level within the residual defect. The results highlight the effectiveness of the protocol:

• Overall success rate: 96.7% of patients show a result rated as "good" at 3 months.
• Filling level: For 96.7% of subjects, the filling level of the cavity with the bone substitute is greater than 40%.

Complications observed

Despite overall convincing results, clinical vigilance remains essential. The study reports one specific case (3.3%) of post-operative complication: the appearance of a fistula at the bone graft site, identified during the 1-month follow-up visit. This case highlights the importance of rigorous follow-up and post-operative hygiene to prevent late failures, particularly in the context of initially infected cysts.

Analysis of results and clinical perspective

The results of this cross-sectional study conducted on 30 patients highlight the efficacy of combining artificial bone and Platelet-Rich Plasma (PRP) in the treatment of radicular cysts. The overall success rate of 96.7% at three months, characterized by healthy healing and bone gap filling exceeding 40%, validates the clinical relevance of this combined protocol.

Observation of healing kinetics provides valuable insights: while 70% of surgical sites are considered healthy at one week, this rate reaches 93.3% by the first month. This acceleration of tissue maturation is characteristic of the contribution of growth factors contained in PRP. However, the occurrence of one case of fistula at the graft site highlights that the technique is not without risks. The authors emphasize a major limitation: the initial infectious state of the cyst. An active infection can compromise the integration of the bone substitute and promote postoperative complications.

Although the sample of 30 cases is modest and the follow-up limited to 90 days, the data corroborate the observations in the literature (notably Nagaveni and Cao) on the benefits of platelet concentrates in oral surgery. The quality of postoperative hygiene and the rigorous management of prior infection appear to be the two pillars conditioning the success of the grafting.

Summary of results

The study conducted on 30 patients demonstrates that the combination of synthetic bone and PRP after radicular cyst enucleation achieves a 96.7% clinical success rate at 3 months. Data show infection-free healing in 70% of subjects from the first week, rising to 93.3% after one month, with bone filling of the cavity consistently exceeding 40% at the end of follow-up.

In concrete terms, for the practitioner:

• Manage infection before grafting: Be cautious with initially infected cysts; the study suggests that these cases increase the risk of postoperative complications and may compromise biomaterial integration.
• Monitor the risk of fistula: Despite the benefits of PRP, a case of fistula on grafted bone was reported at one month; rigorous clinical follow-up during this window is essential to validate mucosal stability.
• Optimize filling: The addition of PRP to synthetic bone is a reliable strategy to secure bone regeneration in cavitary defects, ensuring a significant regenerated volume in just 12 weeks.

The management of bone loss after the enucleation of a radicular cyst remains a major clinical challenge in oral surgery. A clinical study conducted by Dr. Lê Đức Thành's team (National Hospital of Odonto-Stomatology, Vietnam), published in June 2026, evaluates the effectiveness of combining synthetic bone with Platelet-Rich Plasma (PRP) in this specific protocol.

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