Clinical success of platelet-rich fibrin and mineral trioxide aggregate (MTA) or MTA-like agents in healing of periapical lesion in nonsurgically treated pulpless immature permanent teeth: A systematic review

Joshi, Sourabh Ramesh; Palekar, Aparna; Pendyala, Gowri; Mopagar, Viddyasagar; Padmawar, Neeta; Shah, Pranav R.

doi:10.4103/jispcd.jispcd_97_20

Cited by 14 publications

(13 citation statements)

References 18 publications

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“…Narang et al [92] came to a different conclusion, observing better efficacy of PRF than PRP and BC in promoting healing of periapical lesions. The high efficacy of PRF in REP and treatment of inflammation was also confirmed in other reports [72,91,93,94].…”

Section: Components Of the Pulp Regeneration Processsupporting

confidence: 83%

Regenerative Endodontics as the Future Treatment of Immature Permanent Teeth

2021

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The regenerative endodontic procedure (REP) is an alternative solution for endodontic treatment of permanent teeth with incomplete root apex development. It results in angiogenesis, reinnervation, and further root formation. Indications for REP include immature permanent teeth with necrotic pulp and inflammatory lesions of the periapical tissues. The main contraindications comprise significant destruction of the tooth tissues and a lack of patient cooperation. We distinguish the following stages of this procedure: disinfection of the canal, delivery of the REP components, closure of the cavity, and follow-up appointments. For effective canal disinfection, the use of both rinsing agents and intracanal medicaments is suggested. Sodium hypochlorite and triple antibiotic paste are used most commonly. Light-activated disinfection is proposed as an alternative method. The prerequisite for the regeneration process of the pulp is the supply of its essential components: stem cells, growth factors, and scaffolds to the canal lumen. Blood clotting, platelet-rich plasma, and platelet-rich fibrin are used for this purpose. For a proper course of REP, it is also necessary to close the tooth canal tightly. For this purpose, mineral trioxide aggregate (MTA), tricalcium silicate (Biodentine), or types of glass ionomer cement are employed. The patient should attend regularly scheduled follow-up appointments and each time undergo a thorough interview, physical and radiological examination. The most important indicator of a successful REP is the continued growth of the root in length and thickness and the closure of the root apex visible on X-rays. Many different proposals for a management protocol have been published; the following paper proposes the authors’ original scheme. Regenerative endodontics is the future of the endodontic treatment of immature permanent teeth; however, it still requires a lot of research to refine and standardize the treatment protocol. The application of tissue engineering methods seems to be promising, also for mature teeth treatment.

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Section: Components Of the Pulp Regeneration Processsupporting

confidence: 83%

Regenerative Endodontics as the Future Treatment of Immature Permanent Teeth

2021

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“…The use of MTA provided a good apical sealing ability because of the release of calcium and hydroxyl ions from the set matrix. [ 16 ] The osseous regeneration in the present case can be attributed to the regeneration potential of the PRF membrane [ Figure 1f ].…”

Section: Discussionmentioning

confidence: 76%

Application of cone-beam computed tomography in the management of dilacerated maxillary central incisor associated with radicular cyst and external root resorption - A case report

Manjushree

Prasad

2021

J Conserv Dent

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The maxillary anterior region is the most common site for the occurrence of radicular cyst in permanent dentition, because of a high frequency of trauma in this region. As radicular cyst is categorized as an inflammatory cyst, endodontic treatment of the tooth associated with the cyst becomes a part of the treatment regimen. Management of radicular cyst becomes challenging when it involves tooth with complex root morphology. This report presents the diagnosis and successful management of a dilacerated maxillary central incisor associated with a radicular cyst and external root resorption. Cone-beam computed tomography was used to view the extent of the cyst and understand the aberrant root canal morphology of the dilacerated tooth. Root canal therapy was followed by cyst enucleation, apicoectomy, and placement of platelet-rich fibrin. At 1-year recall, appreciable healing as evidenced by a decrease in the size of the radiolucency on the radiographic examination was seen.

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“…It has been proven that platelet concentrates are able to stimulate apical closure [21]. Although the impact of PRF on healing of the periapical lesions in immature necrotic teeth has been discussed by many researchers, the results are not unequivocal [22,23]. PRF may be considered as an ideal bioscaffold to increase proliferation and differentiation of cells that take part in the process of tissue repair [24].…”

Section: Discussionmentioning

confidence: 99%

Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: Case Reports

Machut

Zółtowska

Pawłowska

et al. 2021

IJMS

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Platelet-rich fibrin (PRF) is an autologous blood concentrate obtained without anticoagulants by centrifugation of patients’ peripheral venous blood. PRF is considered to enhance the formation of new bone. The aim of this manuscript was to present two case reports of permanent teeth with closed apexes with periapical lesions, treated endodontically with the use of PRF. The root canals were mechanically cleaned and shaped with NiTi files and irrigated with 5.25% sodium hypochlorite (NaOCl), 40% citric acid (CA), and triple distillated water. Before the canal systems were obturated, A-PRF was used as a scaffold and was placed below the cementodentinal junction with hand pluggers. Cone beam computerized tomography (CBCT) was used to assess the resolutions of periapical radiolucencies. After 6 months, the measurements of both periapical lesions were significantly reduced. Although the performed root canal treatments (RCTs) can definitely be recognized as successful, it must be emphasized that mechanical shaping and cleaning of the root canals with special disinfecting solutions significantly affect the clinical efficacy of RCT. It seems impossible to state that PRF played a leading role in the healing process of the presented periapical lesions. Further studies must be performed to assess whether RCT of mature teeth with an additional PRF application is superior to RCT performed alone.

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Clinical success of platelet-rich fibrin and mineral trioxide aggregate (MTA) or MTA-like agents in healing of periapical lesion in nonsurgically treated pulpless immature permanent teeth: A systematic review

Cited by 14 publications

References 18 publications

Regenerative Endodontics as the Future Treatment of Immature Permanent Teeth

Regenerative Endodontics as the Future Treatment of Immature Permanent Teeth

Application of cone-beam computed tomography in the management of dilacerated maxillary central incisor associated with radicular cyst and external root resorption - A case report

Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: Case Reports

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