Abstract
Surgical endodontics is the last resort to manage persistent periapical lesions, which do not respond to conventional endodontic treatment. The rationale of periapical surgery is to remove all infected tissues and provide a sealed environment that promotes the healing of periradicular tissues. In order to enhance healing, several biomaterials have been utilized, such as bone grafts, collagen membranes, and platelet concentrates. This case report presents two cases of surgical management of a periapical lesion in failed primary endodontic treatment in the maxillary first premolar and first molar by apicoectomy and the use of platelet-rich fibrin (PRF) for bone regeneration and tissue healing. Both cases were diagnosed as periapical granuloma and showed considerable radiographic bone fill at six and 12 months of follow-up, demonstrating the benefits of PRF in surgical endodontics.