Comparative Study between Revitalization of Necrotic Immature Permanent Anterior Teeth with and without Platelet Rich Fibrin: A Randomized Controlled Trial

Abstract

Objectives: This study was conducted to evaluate the effect of platelet rich fibrin (PRF) during revitalization of necrotic immature permanent anterior teeth after 6 months and 1 year follow up period. The following treatment protocols; Group A: revitalization using blood clot scaffold only, and Group B: revitalization using blood clot and PRF. Study design: twenty-two patients (7–12 years old) suffering from immature necrotic permanent maxillary central incisors were randomly selected and randomly allocated into 2 groups. Clinical examinations were performed to detect any pain or swelling during the follow up period. Standardized radiographs were digitally evaluated for changes in root length, periapical radiolucency size, presence of apical or cervical calcific bridges. Results: After a follow-up period of 12 months, most of the cases showed radiographic evidence of periapical healing and showed calcific bridges either cervical and/or apical. No significant differences were shown between both groups. Conclusions: The revitalization procedures succeeded to show continued development of roots in teeth with necrotic pulps. The use of PRF was not essential for repair but it helped during the procedures.

Effectiveness of Autologous Platelet Concentrates in Management of Young Immature Necrotic Permanent Teeth—A Systematic Review and Meta-Analysis

“…This review included a total of 10 randomized clinical trials assessing the effectiveness of APCs in the management of young, immature, necrotic, permanent teeth [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. The included articles were identified from a pool of 3537 articles retrieved from digital databases and a manual search, after removal of duplicates.…”

“…Only two studies [ 29 , 34 ] were assessed to be at low risk, whereas eight studies [ 30 , 31 , 32 , 33 , 35 , 36 , 37 , 38 ] were at moderate risk of bias ( Table 3 ).…”

“…There was uncertainty in defining proper allocation concealment in most of the studies [ 30 , 32 , 35 , 36 , 37 , 38 ], along with blinding in few studies [ 31 , 32 , 33 , 35 , 36 , 37 , 38 ]. The aforementioned reasons led to moderate overall risk assessment in the above cited studies.…”

“…The meta-analysis was carried out with quantitative outcome data extracted from seven included trials [ 30 , 31 , 32 , 34 , 35 , 36 , 38 ]. A blobbogram of the respective outcomes was plotted to compare the effectiveness of APCs in comparison to BC for treatment of young, immature, necrotic, permanent teeth.…”

“…Only one study [ 31 ] recorded calcific barrier formation and found that 8 out of 11 teeth treated with PRF showed calcific barrier formation, among which seven teeth developed an apical barrier and only one tooth developed a cervical barrier at the end of 12 months of follow-up. Similar data were reported for the group treated with BC.…”