Use of platelet-rich plasma for regeneration in non-vital immature permanent teeth: Clinical and cone-beam computed tomography evaluation

Abstract

ObjectiveThis study was performed to assess the clinical and radiological outcomes of a revascularization procedure in immature teeth with apical periodontitis using platelet-rich plasma (PRP). The PRP protocol and conventional revascularization protocol, which used a blood clot as the scaffold, were compared.MethodsThirty non-vital immature permanent teeth were randomly categorized into two groups. After disinfecting the root canal space with triple antibiotic paste (1:1:1 ciprofloxacin, metronidazole, and cefaclor), a tissue scaffold was created using either PRP or a blood clot (control) and covered with white mineral trioxide aggregate. All cases were followed up clinically and radiographically for 12 months. Differences in bone density, root length, and lesion size were calculated using preoperative and postoperative computed tomography images. The means of the differences in individual parameters in the blood clot and PRP groups were compared using the Mann–Whitney U test.ResultsAfter 5 months, sensitivity tests (cold and electric pulp tests) elicited a delayed positive response in 23 sites. At 12 months, cone-beam computed tomography revealed resolution or a decrease in lesion size and an increase in bone density in all 30 (100%) teeth. Additionally, continued root development was observed in 22 (73%) teeth and early root growth was observed in the test group (mineral trioxide aggregate with PRP).ConclusionsThe results of this study suggest that PRP can serve as a successful scaffold for regenerative endodontic treatment. With the exception of a significant increase in root length, the results of treatment with PRP were not significantly different from those of the conventional protocol using a blood clot as the scaffold.

The effect of platelet‐rich plasma as a scaffold in regeneration/revitalization endodontics of immature permanent teeth assessed using 2‐dimensional radiographs and cone beam computed tomography: a randomized controlled trial

“…2015, Alagl et al . 2017) and reduction in periapical areas in favour of PRP in two studies (Jadhav et al . 2012, Narang et al .…”

“…Radiographic outcomes of RET have been mainly assessed using 2‐dimensional radiographic views (Table 1), most of which reported no significant differences between the RET‐BLC and RET‐PRP (Table 1). Assessment of RET outcomes using cone beam computed tomography (CBCT), however, has only been performed by Alagl et al (2017) who reported no differences between BLC and PRP in all outcomes except for root lengthening where a significant increase in favour of the PRP group was reported. The use of CBCT over 2‐dimensional radiographic views could improve visualization of root development in three dimensions, hence it has been suggested for use in assessment of root development; however, these two techniques have not been compared for such a recommendation to be made.…”

Revitalisation endodontic treatment of traumatised immature teeth: a prospective long-term clinical study

“…Other standardisation and or image calibration techniques such as the use of paralleling devices with impression bite registration (Dabbagh et al 2012), the use of Schei's Ruler (Santhakumar et al 2018) and the use of TurboReg plug-in software (Bezgin et al 2015) has been reported. The use of Cone Beam Computed Tomography has also been reported in one study (Alagl et al 2017). To date, however, no study has compared the effectiveness of using such techniques over the standard use of paralleling techniques.…”

Histological assessment of human regenerative endodontic procedures (REP) of immature permanent teeth with necrotic pulp/apical periodontitis: A systematic review

“…Necrotic teeth sensitivity reestablishment is one of the best results of RET. There are several reports of teeth that gave positive reactions to electric and cold stimuli . Although positive reaction to electric stimuli occurred 5 months after RET, it is yet unclear when neurogenesis starts.…”