Platelet-Rich Plasma and Platelet-Rich Fibrin Can Induce Apical Closure More Frequently Than Blood-Clot Revascularization for the Regeneration of Immature Permanent Teeth: A Meta-Analysis of Clinical Efficacy

Abstract

The purpose of this review was to compare the clinical efficacy of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), vs. blood clot revascularization (BCR) for the regeneration of immature permanent teeth. A survey of the literature identified 222 cases of immature permanent teeth which had been given PRP, PRF or BCR regeneration treatment with at least a year-long follow-up in 12 different articles. A meta-analysis of the 222 immature permanent teeth after 1 year, were compared to assess the ability of PRP, PRF, and BCR to accomplish apical closure, a periapical lesion healing response, root lengthening, and dentinal wall thickening. The mean success rate for apical closure or reduction after 1 year was: PRP (85.1%) PRF (85.2%), and BCR (58.8%). The mean success rate for root lengthening after 1 year was: BCR (64.1%), PRP (64.2%), and PRF (74.1%). The periapical lesion healing response was 88.9% for BCR, 100% for PRP, and 100% for PRF. Dentinal wall thickening was 100% for BCR, 100% for PRP, and 100% for PRF. Apical closure occurred more frequently following PRP and PRF than with BCR (Fischer test, P < 0.0011), for all the other effects the PRP, PRF, and BCR treatments were similarly effective (Fischer tests, P > 0.05). In conclusion, the fractured or decayed immature permanent teeth of children and young adults aged 6 years to 28 which have a restorable crown, but thin dentinal walls may be regenerated by using a revascularization procedure which draws blood and stem cells into a disinfected root canal space. Although BCR is most common revascularization method, apical closure may occur more frequently if PRF and PRP are used instead of BCR for the regeneration of immature permanent teeth. The proper use of regenerative procedures can be very successful at the disinfection of bacteria from the periapical region of immature permanent teeth, which helps to heal localized lesions, and avoid the need for complex apical surgery, in addition to regenerating tissues to strengthen the structure of immature teeth, to help prevent tooth fracture and tooth loss.

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). Systematic reviews and meta‐analyses, assessing the success of RET using BLC and PRP/PRF, have shown an excellent chance of success, tooth survival and resolution of periapical pathosis with inconsistencies in apical closure and continued root development (Murray 2018, Metlerska et al . 2019).…”

“…2017, Torabinejad et al . 2017, Murray 2018) has provided the opportunity to offer RET to complement MTA apical plug techniques especially in immature teeth at an early stage of root development (stages 1, 2 or 3; Cvek 1992, Nazzal & Duggal 2017).…”

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

“…Current REPs remain unable to reinstate physiological structure and function, but they can induce the development of new vascularized tissue in the root-canal space. This guided endodontic repair process allows for continuing root development, thickening of root canal walls, apical closure, and complete resolution of apical periodontitis [ 9 ].…”

The use of platelet-rich plasma in medicine with particular reference to dentistry and aesthetic medicine

“…When such teeth are fractured or damaged, their crowns are restored, but thin dentine walls can be regenerated using PRP. 18 Maxillo-facial surgery is a department of dentistry in which platelet-rich plasma is used on a large scale, among others, to accelerate bone regeneration in the implantation of dental prostheses and to obtain a faster implant integration after reconstruction of the jaw bone or paranasal sinuses with autologous bone graft. 1,3,19 PRP is also administered after tooth extraction for faster regeneration of alveolar tissues.…”

“…Złamane lub uszkodzone niedojrzałe zęby stałe osób w wieku od 6 do 28 lat, które mają odbudowaną koronę, ale cienkie ściany zębiny można zregenerować za pomocą PRP. 18 Chirurgia twarzowo-szczękowo jest działem stomatologii, w którym osocze bogatopłytkowe stosuje się na szeroką skalę. Wykorzystywane jest do przyspieszenia regeneracji kości w implantacji wszczepów zębowych 3 oraz w celu uzyskania szybszej integracji przeszczepu w rekonstrukcji kości szczęki lub zatok przynosowych autologicznym przeszczepem kości.…”