Evaluation of amniotic membrane in the healing of apicomarginal defects using 2D and 3D imaging modalities: a randomized controlled trial

Objective: The study aimed to evaluate healing in apicomarginal defects with amniotic membrane (AM) using 2D periapical radiography and 3D cone beam computed tomography imaging.
Method and materials: Thirty-four patients with symptomatic apical periodontitis and apicomarginal communication were allocated to either the AM or control group. Clinical and radiographic assessment was performed at baseline and at 12 months using Molven criteria, modified Penn 3D criteria, and RAC and B indices at resected plane, apical area, cortical plate, and combined apicocortical area, respectively.
Results: There was no significant difference in the healing outcome in 2D imaging (93.3% control and 86.7% AM) and 3D imaging (80.0% control and 53.3% AM) between the groups. With RAC scoring, a greater percentage of unhealed cases was observed in cortical plate. Radiographic buccal bone formation in the 3D imaging was evident only in six cases. However, both the groups depicted significantly greater percentage reduction in the size of the lesion in 2D than the 3D analysis (AM group 91.69 ± 15.99 2D, 76.06 ± 47.62 3D, P = .020) and (control group 92.06 ± 14.36 2D, 85.12 ± 18.55 3D, P = .005).
Conclusion: No significant difference in healing was observed between the AM and the control groups with the use of both periapical radiography and CBCT imaging. Despite good clinical healing and radiographic apical bone fill, buccal bone formation was not evident in 3D imaging in most of the cases.