A comparison of two pulp revascularization techniques using platelet-rich plasma and whole blood clot

Ramachandran, Naren; Singh, Shishir; Podar, Rajesh; Kulkarni, Gaurav; Shetty, Roshan; Chandrasekhar, Padmini

doi:10.4103/jcd.jcd_221_20

Cited by 14 publications

(29 citation statements)

References 38 publications

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“…The primary search resulted in 1272 papers published between 2012 and 2022; of these, 23 met the initial inclusion criteria. Reading of complete texts resulted in the inclusion of 16 studies, 14 case-control studies [12,14,15,[31][32][33][34][35][36][37][38][39][40][41]and two split-mouth studies[16, 42](Fig. 1).…”

Section: Search Resultsmentioning

confidence: 99%

“…The RoB varied among the included studies. Only one [32] was regarded as having a low RoB, whereas eight had an unclear [12,14,15,31,34,37,38,40] and seven had a high[16, 33,35,36,39,41,42] RoB. Because of the nature of the treatment, allocation could not be concealed and patients could not be blinded to treatment, as blood was drawn from the patients who received platelet concentrates.…”

Section: Discussionmentioning

confidence: 99%

“…Of the 465 teeth included in the control and experimental groups of the analyzed studies, 457 (98.2%) remained clinically asymptomatic for the entire study duration. Only eight (1.8%) teeth showed signs and symptoms of failure, including spontaneous pain, sensitivity to percussion or reinfection [36,37,41]. This meta-analysis included eight RCT parallel studies [12,14,15,31,32,34,38,41], one split-mouth study [16], and one case-control study [33].…”

Section: Discussionmentioning

confidence: 99%

“…One study found that two patients in the BC group and one in the PRP group presented with signs of reinfection at the second recall appointment after 6 months[36], whereas another article described four patients with pain, but their treatment was not reported [37].…”

Section: Image J Softwarementioning

confidence: 99%

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Are platelet concentrate scaffolds superior to traditional blood clot scaffolds in regeneration therapy? A systematic review and meta-analysis

Tang

Jin

Lin

et al. 2022

Preprint

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Background The effectiveness of platelet concentrates in promoting root development of necrotic immature permanent teeth is unclear. The present study evaluated whether the platelet concentrate protocol was superior to the traditional blood clot protocol in regeneration therapy. Methods Electronic databases, such as PubMed, Cochrane Library, ClinicalTrials and EMBASE, were searched for studies comparing these protocols, with identified studies manually searched for relevant references. Clinical case-control studies were included, in which platelet-rich concentrates were tested for pulp regeneration and radicular development, with the blood clot treatment protocol as the control group. Clinical and radiographic outcomes were considered.Selected articles were assessed for risk of bias. Pooled Risk ratios were calculated for clinical success, responses to cold and electric pulp tests, periapical lesions, apex closure, root lengthening, and thickening of the dentin walls. Heterogeneity was assessed using I2 statistics and Cochrane’s Q test. Results Of the 1272 screened studies, 16 were selected, 14 case-control and two split-mouth studies, in which 465 immature necrotic permanent teeth, particularly incisors and premolars, were treated. Of these 465 teeth, 457 (98.2%) in both the control and experimental groups remained clinically asymptomatic for the entire study duration, whereas eight (1.8%) showed signs and symptoms of failure, including spontaneous pain, sensitivity to percussion or reinfection. Compared with control teeth, teeth treated with platelet-rich plasma or platelet-rich fibrin showed improved periapical healing (RR 1.09, 95% CI 1.00–1.20, P = 0.05), apical closure (RR 1.04, 95% CI 0.86–1.25, P = 0.69), root lengthening (RR 1.01, 95% CI 0.74–1.39, P = 0.93), and thickening of the dentin walls (RR 1.32, 95% CI 0.96–1.81, P = 0.08), although these differences were not statistically significant. Conclusions Platelet concentrates can act as successful scaffolds for regenerative endodontic treatment, although they did not differ significantly from conventional blood clot scaffolds.

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Section: Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Image J Softwarementioning

confidence: 99%

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Are platelet concentrate scaffolds superior to traditional blood clot scaffolds in regeneration therapy? A systematic review and meta-analysis

Tang

Jin

Lin

et al. 2022

Preprint

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“…With the aid of the CAB technique, this powerful technique can be used safely even in cases of teeth with open apices. [ 2 14 22 23 24 25 26 ]…”

Section: Discussionmentioning

confidence: 99%

An innovative technique to safely perform active cleaning in teeth with open apices: CAB technique

et al. 2021

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The current study aims to evaluate in vitro the extrusion of NaOCl, using an artificial root canal with an open apex, using different canal irrigation protocols. For this study, a transparent artificial root canal was used. The apex was shaped to be oversized and irregular in form. After root canal mechanical shaping, the artificial cylindrical chamber, which was made below the large apical foramen, was filled with fuchsine-stained bovine pulp tissue. Afterward, irrigation protocols were carried out and compared regarding their safety with regards to irrigant extrusion. Subsequently, the examiner created two groups, Group A: internal heating associated with ultrasonic activation and Group B: internal heating associated with ultrasonic activation, using the CAB technique. In both the groups, 5.25% sodium hypochlorite solution was used as the irrigant. Regarding assessing the presence or absence of the extrusion, photographs at ×20 were taken and analyzed. For the statistical analysis, a t -test for paired samples was used. Extrusion of irrigant beyond the apex was present only in Group A. The main objective of endodontic treatment is the removal of damaged tissues and bacteria. For this reason, active cleaning is crucial in all endodontic treatment cases. Internal heating followed with ultrasonic activation while using the CAB technique was an effective and safe technique to ensure no irrigant extrusion beyond the open apex.

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Expert consensus on regenerative endodontic procedures

Wei

Yang

Lin³

et al. 2022

Int J Oral Sci

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Regenerative endodontic procedures (REPs) is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis. The ultimate objective of REPs is to regenerate the pulp-dentin complex, extend the tooth longevity and restore the normal function. Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports, case series, cohort studies, and randomized controlled studies. However, variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics. The heterogeneity in protocols may cause confusion among dental practitioners, thus guidelines and considerations of REPs should be explicated. This expert consensus mainly discusses the biological foundation, the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis, as well as the main complications of this treatment, aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies, suggesting REPs may become a more consistently evidence-based option in dental treatment.

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A comparison of two pulp revascularization techniques using platelet-rich plasma and whole blood clot

Cited by 14 publications

References 38 publications

Are platelet concentrate scaffolds superior to traditional blood clot scaffolds in regeneration therapy? A systematic review and meta-analysis

Are platelet concentrate scaffolds superior to traditional blood clot scaffolds in regeneration therapy? A systematic review and meta-analysis

An innovative technique to safely perform active cleaning in teeth with open apices: CAB technique

Expert consensus on regenerative endodontic procedures

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