The recovery of periapical defects linked to periodontal communication frequently yields less satisfactory results. Numerous studies and case reports have highlighted the notable success achieved through the application of guided tissue regeneration techniques. More recently, autologous platelet concentrate plug \& placental membrane have emerged as a treatment option for addressing such lesions. Nevertheless, there has been no study using PRF-Medium with ACM membrane on the healing of aforesaid lesion \& quality of life assessment.
Patients of age 16yrs and above.
Patients with apico-marginal defects and deep pocket upto apex of tooth.
Failed primary root canal treatment.
Presence of interproximal bone loss.
Presence of vertical root fracture
Presence of root perforations
ASA-3 or ASA-4 according to the classification of the American Society of Anesthesiologists)
Presence of root resorption
Parallel
Endodontic Micro-Surgery
Procedure/SurgerySurgery performed using ACM membrane and PRF plug in test group \& without membrane \& PRF in control group.
Periapical healing assessment
Periapical healing comparison in 2 groups 2D radiographic healing by Rud et al and Molven et al criteria and 3D healing by modified PENN 3D Criteria. Healing will be categorised into complete, incomplete, uncertain, unsaisfactory.
Quality of life assessment
to assess pain, swelling, mouth opening and effect on daily activities of patient among test and control group using OHIP-14 questionnaire. Pain Assesment with Value 0 indicate no pain \& 100 indicate maximum pain.
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