Revascularization Induced Maturogenesis of Non-Vital Immature Teeth Using Different Scaffolds and Intra Canal Medications

Abstract

Purpose: to clinically and radiographically evaluate revascularization induced maturogenesis of non-vital immature teeth using Platelets rich plasma (PRP) compared to blood clot as scaffolds with two different intracanal medications [modified triple antibiotic paste (mTAP) and calcium hydroxide (Ca(OH) 2 ) mixed with chlorhexidine (CHX)]. Materials and Methods: 32 patients aged between 9 and 20 years requiring endodontic therapy of maxillary central incisors were selected for this study. Patients were randomly divided into four equal groups (n=8) according to type of scaffold and intracanal medication used in the treatment as; Group I: Blood clot scaffold/ mTAP intra canal medication ,Group II: PRP scaffold/mTAP intra canal medication, Group III: Blood clot scaffold/Ca(OH) 2 mixed with CHX intra canal medication, Group IV: PRP scaffold/ Ca(OH) 2 mixed with CHX intra canal medication. Patients were evaluated clinically for presence or absence of spontaneous pain, pain on palpation, swelling, sinus tract or crown discoloration and radiographically for any change in apical foramen diameter, root length and root canal diameter at a predetermined point at 15mm from the incisal edge. Radiographic digital examination was done immediately postoperative and at 3,6,9 and 12months of follow-up under the same circumstances. Results: Clinically, all patients were completely asymptomatic through out the study. Radiographically, concerning percentage of root length increase, PRP produced superior results with statistically significant difference compared to blood clot as a scaffold while mTAP showed significantly better results compared to Ca(OH) 2 mixed with CHX as intracanal medication. Concerning percentage of canal diameter decrease and apical foramen diameter decrease, using PRP scaffold with mTAP medication produced superior results with statistically significant difference when compared to blood clot scaffold with a mix of Ca(OH) 2 and CHX medication respectively. Conclusions: PRP is better than Blood clot as a scaffold and mTAP is better than Ca(OH) 2 mixed with CHX as an intracanal medication when they are used during revascularization of immature teeth.