**5.6 Apicoectomy with extraoral fistula excision on the face**

This is a very interesting case of a patient with an extraoral fistula on the face that has dental etiology (**Figure 15**). The patient had been mistreated for a longer period as the facial pathology had been considered a dermatologic condition.

*PRF and Sticky Bone as Regenerative Materials in Oral Surgery DOI: http://dx.doi.org/10.5772/intechopen.108807*

#### **Figure 15.**

*Large extraoral fistula of dental origin. (A) Extraoral fistula. (B) Tooth 13 with periapical radiolucency causes the infection. (C) Definitive canal obturation. (D) The appearance of fistula during endodontic treatment. (E) Intraoral view. (F) Periapical lesion. (G) Root resected. (H) PRF membranes placed over the operating wound. (I) Flap repositioned and sutured. (J) Sinus tract. (K) Extraoral fistula was extirparted, two PRF membranes were placed in the hole, and the wound was sutured. (L) Almost invisible scar on the face.*

The examination by the oral surgeon set the correct diagnosis. It was an infection of a dental etiology of tooth 13 that resulted in a periapical lesion, which was not treated and has consequently resulted in an extraoral fistula. The therapeutic approach entailed endodontic treatment of the tooth 13. During the treatment, the extraoral fistula on the face was regressing. Upon competition of definite root obturation of the tooth 13, apicoectomy ensued and was followed by the removal of the periapical bony lesion as well as excision of the canal of the fistula. For the oral wound to heal well, two PRF membranes were placed. Throughout the opening on the face, additional two PRF membranes were extraorally placed. Three months after the surgery, it can be noted (**Figure 13L**) that intraoral healing was excellent with almost unnoticeable scar extraorally.

### **6. Conclusion**

Platelet concentrates were discovered by manipulating normal physiological processes such as hemostasis. All known platelet concentrates are high in growth factors and so have tremendous potential in regeneration processes. PRF, BIO-PRF, Alb-PRF, and sticky bone are newer generations of platelet concentrates that will influence the direction of regenerative dentistry. In the future, we may expect a greater number of clinical trials that will investigate the full potential of novel platelet concentrates.

### **Conflict of interest**

The author declares no conflict of interest.
