Apical surgery can enhance the success of restoring certain endodontically treated teeth. New regenerative surgical modalities, with emphasis on guided tissue regeneration, or GTR, have expanded clinicians' ability to retain teeth that previously were considered to be beyond restoration. The retrospective clinical study described in this article demonstrates that the use of GTR without the use of allograft demineralized bone achieves regeneration that is clinically and radiographically indistinguishable from the surrounding bone. The author presents the indications and contraindications for case selection, surgical management and postoperative findings for this treatment option.