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Research Article
Evaluation of blood clot, platelet-rich plasma, and platelet-rich fibrin–mediated regenerative endodontic procedures in teeth with periapical pathology: a CBCT study
Swati Markandey, Haridas Das Adhikari
Restor Dent Endod 2022;47(4):e41.   Published online October 21, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e41
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Objectives

This study compared the clinical and radiological outcomes of regenerative endodontic procedures (REPs) using blood clots (BCs), platelet-rich plasma (PRP), and platelet-rich fibrin (PRF) through intraoral periapical radiography (IOPAR) and cone-beam computed tomography (CBCT).

Materials and Methods

Forty-five single-rooted necrotic teeth with periapical pathology were randomly allocated to receive BC, PRP, or PRF as an individual scaffold. Outcomes were evaluated in 35 teeth in 23 patients with a follow-up period of 12–24 months through qualitative IOPAR scoring and quantitative CBCT measurements. Healing of periapical lesions and in immature teeth, changes in the apical foramen diameter (AFD), root wall thickness (RWT), and root length (RL) were assessed. A p value less than 0.05 was considered to indicate statistical significance.

Results

All teeth were asymptomatic except 1 in the PRP group. Periapical lesion healing was seen in all except 2 teeth in the BC group and 3 in the PRP group. Both IOPAR and CBCT revealed no significant differences in bone healing or changes in AFD, RWT, and RL among the 3 groups. A positive pulp sensibility response to the cold test was seen in 2 teeth in the BC group, but none to the electric pulp test. Intracanal calcification (ICC) was evident in more teeth in the BC group than in the PRP and PRF groups, and was also significantly higher in immature teeth.

Conclusions

Our results revealed that BC, PRP, and PRF have similar potential as scaffolds in REPs, and ICC may be a concern for long-term outcomes.

Citations

Citations to this article as recorded by  
  • Regenerative potential of concentrated growth factor compared to platelet-rich fibrin in treatment of necrotic mature teeth: a randomized clinical trial
    Taghreed Salah, Wael Hussein, Heba Abdelkafy
    BDJ Open.2025;[Epub]     CrossRef
  • Biomimetic pulp scaffolds prepared from extracellular matrix derived from stem cells from human exfoliated deciduous teeth promote pulp–dentine complex regeneration
    Ning Yang, Rou Shen, Wenxiao Yang, Shengcai Zhang, Tianxing Gong, Yao Liu
    International Endodontic Journal.2024; 57(9): 1279.     CrossRef
  • Arrest and Repair of Inflammatory Root Resorption After an Endodontic Regeneration Procedure – A Hypothesis and Case Report
    Arieh Y. Kaufman, Bill Kahler
    Journal of Endodontics.2024; 50(12): 1743.     CrossRef
  • Effect of Platelet Rich Plasma in Regenerative Endodontic Treatment: A Review of Clinical Trials
    Hojat Rezazadeh, Mehrnaz Okhovatfard
    Research Journal of Pharmacy and Technology.2023; : 5562.     CrossRef
  • 598 View
  • 23 Download
  • 3 Web of Science
  • 4 Crossref
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Case Report
Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion
Lata Goyal
Restor Dent Endod 2014;39(1):51-55.   Published online January 20, 2014
DOI: https://doi.org/10.5395/rde.2014.39.1.51
AbstractAbstract PDFPubReaderePub

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

Citations

Citations to this article as recorded by  
  • To Analyze the Efficacy of Platelet-rich Plasma in Contrast to Platelet-rich Fibrin along with Synthetic Nanocrystalline Hydroxyapatite and β-tricalcium Phosphate Bone Graft in Regeneration of Bony Defects in Children
    Anshul Sharma, Sonali Saha, Amit Rai, Kavita Dhinsa, Nonie Marianne Koksi Sangma Shadap, Gunjan Yadav
    International Journal of Clinical Pediatric Dentistry.2024; 16(6): 842.     CrossRef
  • Regenerative Endodontic Management of an Immature Necrotic Premolar Using Advanced Platelet-Rich Fibrin
    Sepideh Hosseini, Nazanin Chitsaz, Mohammad Hassan Hamrah, Donya Maleki, Emad Taghizadeh, Hamdi Cem Gungor
    Case Reports in Dentistry.2023; 2023: 1.     CrossRef
  • Effect of biodentine coated with emdogain on proliferation and differentiation of human stem cells from the apical papilla
    Hamed Karkehabadi, Erfan Ahmadyani, Rezvan Najafi, Elham Khoshbin
    Molecular Biology Reports.2022; 49(5): 3685.     CrossRef
  • Healing Assessment of Osseous Defects after Surgical Removal of Periapical Lesions in the Presence of Hydroxyapatite, Nanohydroxyapatite, and a Combination of Nanohydroxyapatite and Platelet-rich Fibrin: A Clinical Study
    Amira Elkholly, Maged Negm, Reham Hassan, Nada Omar
    Open Access Macedonian Journal of Medical Sciences.2022; 10(D): 406.     CrossRef
  • Case report on combining PRF with alloplastic bone substitute in Endo-Perio lesion
    Mansi Bansal, Manish Khatri, Komal Puri
    Restorative Dentistry & Endodontics.2021;[Epub]     CrossRef
  • Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review


    Maria K Makeeva, Fatima Yu Daurova, Svetlana F Byakova, Anna Yu Turkina
    Clinical, Cosmetic and Investigational Dentistry.2020; Volume 12: 447.     CrossRef
  • Revisit to endo-perio lesion a review
    Roopali Sharma, Akshita Gupta, K K. Gupta, Sarah Jameel, Rashmika Kapoor
    IP International Journal of Periodontology and Implantology.2020; 5(2): 48.     CrossRef
  • Autologous platelet-rich derivatives along with alloplastic bone substitute in the management of complex perio-endo cases
    Lata Goyal, Namita Gupta, NarinderDev Gupta
    Journal of Indian Society of Periodontology.2020; 24(2): 182.     CrossRef
  • Platelet-Rich Fibrin as a Bone Graft Material in Oral and Maxillofacial Bone Regeneration: Classification and Summary for Better Application
    Yiping Liu, Xiaolin Sun, Jize Yu, Jia Wang, Peisong Zhai, Siyu Chen, Manxuan Liu, Yanmin Zhou
    BioMed Research International.2019; 2019: 1.     CrossRef
  • Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo‐periodontal lesions
    David Herrera, Belén Retamal‐Valdes, Bettina Alonso, Magda Feres
    Journal of Clinical Periodontology.2018;[Epub]     CrossRef
  • Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo‐periodontal lesions
    David Herrera, Belén Retamal‐Valdes, Bettina Alonso, Magda Feres
    Journal of Periodontology.2018;[Epub]     CrossRef
  • Regenerative in endodontics: how, when and where
    AL Ahmar Rima, Bassam Sanaa, Salloum Sarah, El Husseini Hassan, AL Ahmar Rima
    Journal of Dental Health, Oral Disorders & Therapy.2018; 9(6): 531.     CrossRef
  • Effect of Choukroun Platelet-Rich Fibrin Combined With Autologous Micro-Morselized Bone on the Repair of Mandibular Defects in Rabbits
    Tian Zhou, Hua-Wei Yang, Zhuo-Wei Tian, Yang Wang, Xiao-Shan Tang, Jing-Zhou Hu
    Journal of Oral and Maxillofacial Surgery.2018; 76(1): 221.     CrossRef
  • Preliminary Results of Bone Regeneration in Oromaxillomandibular Surgery Using Synthetic Granular Graft
    Noemi Mazzone, E. Mici, A. Calvo, M. Runci, S. Crimi, F. Lauritano, E. Belli
    BioMed Research International.2018; 2018: 1.     CrossRef
  • Treatment of endo-periodontal lesion using leukocyte- platelet- rich fibrin. A case report
    Pablo Betancourt, Ricardo Elgueta, Ramon Fuentes
    Colombia Medica.2017; 48(4): 204.     CrossRef
  • The impact of autologous platelet concentrates on endodontic healing: a systematic review
    Nastaran Meschi, Ana B. Castro, Katleen Vandamme, Marc Quirynen, Paul Lambrechts
    Platelets.2016; 27(7): 613.     CrossRef
  • A review of the regenerative endodontic treatment procedure
    Bin-Na Lee, Jong-Wook Moon, Hoon-Sang Chang, In-Nam Hwang, Won-Mann Oh, Yun-Chan Hwang
    Restorative Dentistry & Endodontics.2015; 40(3): 179.     CrossRef
  • Platelet preparations in dentistry: How? Why? Where? When?
    Luigi Fabrizio Rodella
    World Journal of Stomatology.2015; 4(2): 39.     CrossRef
  • 214 View
  • 1 Download
  • 18 Crossref
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Review Article
Platelet rich fibrin - a novel acumen into regenerative endodontic therapy
Kavita Hotwani, Krishna Sharma
Restor Dent Endod 2014;39(1):1-6.   Published online January 20, 2014
DOI: https://doi.org/10.5395/rde.2014.39.1.1
AbstractAbstract PDFPubReaderePub

Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF) has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy.

Citations

Citations to this article as recorded by  
  • Apicoectomy versus apical curettage in combination with or without L-PRF application: a randomized clinical trial
    Serap Gulsever, Seyda Ersahan, Yelda Erdem Hepsenoglu, Alperen Tekin
    Scientific Reports.2025;[Epub]     CrossRef
  • Pulp regeneration treatment using different bioactive materials in permanent teeth of pediatric subjects
    Dina Abdellatif, Alfredo Iandolo, Giuseppina De Benedetto, Francesco Giordano, Davide Mancino, Edouard Euvrard, Massimo Pisano
    Journal of Conservative Dentistry and Endodontics.2024; 27(5): 458.     CrossRef
  • Analysis of Pulp Tissue Viability and Cytotoxicity of Pulp Capping Agents
    Pratima Panda, Shashirekha Govind, Sanjit Kumar Sahoo, Satabdi Pattanaik, Rachappa M. Mallikarjuna, Triveni Nalawade, Sanjay Saraf, Naseer Al Khaldi, Salma Al Jahdhami, Vinay Shivagange, Amit Jena
    Journal of Clinical Medicine.2023; 12(2): 539.     CrossRef
  • Implantation Effect of a Fibrin Matrix Associated with Mesenchymal Wharton’s Jelly Stromal Cells on the Course of an Experimental Spinal Cord Injury
    V. V. Medvediev, N. P. Oleksenko, L. D. Pichkur, S. A. Verbovska, S. I. Savosko, N. G. Draguntsova, Yu. A. Lontkovskyi, V. V. Vaslovych, V. I. Tsymbalyuk
    Cytology and Genetics.2023; 57(1): 19.     CrossRef
  • Advanced Platelet-rich Fibrin-mediated Regeneration of Necrotic Immature Permanent Teeth: A Clinico-radiographic Observational Study
    Ashi Chug, Sagrika Shukla, Tulika Wakhloo, Mridul Dhar
    International Journal of Clinical Pediatric Dentistry.2022; 15(4): 402.     CrossRef
  • Effect of Implantation of a Fibrin Matrix Associated with Neonatal Brain Cells on the Course of an Experimental Spinal Cord Injury
    V. V. Medvediev, N. P. Oleksenko, L. D. Pichkur, S. A. Verbovska, S. I. Savosko, N. G. Draguntsova, Yu. A. Lontkovskiy, V. V. Vaslovych, V. I. Tsymbalyuk
    Cytology and Genetics.2022; 56(2): 125.     CrossRef
  • Comparison of Autologous Platelet-Rich Fibrin Matrix and Transplantation of Autologous Noncultured Epidermal Cell Suspension in the Treatment of Chronic Non Healing Ulcer
    Satyendra K. Singh, Sri Rupa
    Indian Journal of Dermatology.2022; 67(4): 334.     CrossRef
  • Effect of amniotic membrane and platelet‐rich fibrin membrane on bone healing post endodontic surgery: An ultrasonographic, randomized controlled study
    Saumya Johri, Promila Verma, Aseem Prakash Tikku, Rhythm Bains, Neera Kohli
    Journal of Tissue Engineering and Regenerative Medicine.2022; 16(12): 1208.     CrossRef
  • Effect of biodentine coated with emdogain on proliferation and differentiation of human stem cells from the apical papilla
    Hamed Karkehabadi, Erfan Ahmadyani, Rezvan Najafi, Elham Khoshbin
    Molecular Biology Reports.2022; 49(5): 3685.     CrossRef
  • SINGLE VISIT- APEXIFICATION USING MTA AND AUTOLOGOUS PRF AS AN INTERNAL MATRIX. A CASE SERIES.
    Deepika Deepika, Abhishek Sharma, Ajay Kumar Nagpal, Muhammad Mutiur Rahman
    INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2022; : 61.     CrossRef
  • COMPARATIVE CLINICAL, RADIOGRAPHICAL AND HISTOLOGICAL EVALUATION OF CORONAL PULPOTOMY TECHNIQUE WITH PRF AND A NOVEL CROSSLINKED PRF AS AN ALTERNATIVE TO PULPECTOMY FOR PRESERVING THE TOOTH VITALITY IN CONTEXT OF TISSUE ENGINEERING.
    Suman Kar, R. R. Paul, H. D. Adhikari, Swagata Gayen, Sandip Sinha
    INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2022; : 84.     CrossRef
  • Clinical Application of Platelet-Rich Fibrin in Pediatric Dentistry
    Sowndarya Gunasekaran, Soundarya Sakthivel, Shanthala B. M., George Babu, Vidhya Vijayan
    Journal of Health and Allied Sciences NU.2022; 12(02): 186.     CrossRef
  • Platelet-Rich Fibrin Used as a Scaffold in Pulp Regeneration: Case Series
    Ceren ÇİMEN, Selin ŞEN, Elif ŞENAY, Tuğba BEZGİN
    Cumhuriyet Dental Journal.2021; 24(1): 113.     CrossRef
  • Treatment of Miller I Mandibular Gingival Recessions Using PRF vs. Connective Graft
    Hernan S. Garzon, Camilo Alfonso, Francisco J. Vega, Andrea García, Ana Muñoz, Gustavo Jaimes, Katherine Isaza, Katherine Rivera, Gaetano Isola
    International Journal of Dentistry.2021; 2021: 1.     CrossRef
  • Human Umbilical Cord Mesenchymal Stem Cells Over Platelet Rich Fibrin Scaffold for Mandibular Cartilage Defects Regenerative Medicine
    Ni Putu Mira Sumarta, David Buntoro Kamadjaja, Nike Hendrijantini, Coen Pramono Danudiningrat, Fedik Abdul Rantam
    Pesquisa Brasileira em Odontopediatria e Clínica Integrada.2021;[Epub]     CrossRef
  • Platelet-Rich Fibrin Enhances Surgical Wound Healing in Total Laryngectomy
    Mirta H. Reksodiputro, Syahrial M. Hutauruk, Dini W. Widodo, Fauziah Fardizza, Dita Mutia
    Facial Plastic Surgery.2021; 37(03): 325.     CrossRef
  • Role of Platelet-Rich Fibrin (PRF) and Platelet-Rich Plasma (PRP) in Oro-Facial Tissue Regeneration: A Narrative Review
    Modhi Al Deeb
    Journal of Advanced Oral Research.2020; 11(1): 5.     CrossRef
  • Efficacy of Autologous Platelet Concentrates in Regenerative Endodontic Treatment: A Systematic Review of Human Studies
    Joanna Metlerska, Irini Fagogeni, Alicja Nowicka
    Journal of Endodontics.2019; 45(1): 20.     CrossRef
  • Autologous platelet-rich-fibrin-induced revascularization sequelae: Two case reports
    Ahmed M Eltawila, Rania El Backly
    World Journal of Stomatology.2019; 7(3): 28.     CrossRef
  • Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach
    Meghna Bajaj, Ashu J Soni
    International Journal of Clinical Pediatric Dentistry.2019; 12(2): 150.     CrossRef
  • Biomimetics in Endodontics: A Review of the Changing Trends in Endodontics
    Jalak Patel, Tejal Sheth, Dhwanit Thakore, Dharmesh Dhamat
    Journal of Advanced Oral Research.2018; 9(1-2): 11.     CrossRef
  • Regenerative in endodontics: how, when and where
    AL Ahmar Rima, Bassam Sanaa, Salloum Sarah, El Husseini Hassan, AL Ahmar Rima
    Journal of Dental Health, Oral Disorders & Therapy.2018; 9(6): 531.     CrossRef
  • Effects of the nitric oxide releasing biomimetic nanomatrix gel on pulp-dentin regeneration: Pilot study
    Chan-Yang Moon, Ok Hyung Nam, Misun Kim, Hyo-Seol Lee, Sagar N. Kaushik, David A. Cruz Walma, Ho-Wook Jun, Kyounga Cheon, Sung Chul Choi, Jinkee Hong
    PLOS ONE.2018; 13(10): e0205534.     CrossRef
  • Growth Factors and Cell Homing in Dental Tissue Regeneration
    Henry F. Duncan, Yoshifumi Kobayashi, Emi Shimizu
    Current Oral Health Reports.2018; 5(4): 276.     CrossRef
  • Use of Leukocyte Platelet (L-PRF) Rich Fibrin in Diabetic Foot Ulcer with Osteomyelitis (Three Clinical Cases Report)
    Alessandro Crisci, Giuseppe Marotta, Anna Licito, Edda Serra, Giulio Benincasa, Michela Crisci
    Diseases.2018; 6(2): 30.     CrossRef
  • Pulp Regeneration Concepts for Nonvital Teeth: From Tissue Engineering to Clinical Approaches
    Valérie Orti, Pierre-Yves Collart-Dutilleul, Sofía Piglionico, Orsolya Pall, Frédéric Cuisinier, Ivan Panayotov
    Tissue Engineering Part B: Reviews.2018; 24(6): 419.     CrossRef
  • Long-term cytokine and growth factor release from equine platelet-rich fibrin clots obtained with two different centrifugation protocols
    Román F. Jiménez-Aristizabal, Catalina López, María E. Álvarez, Carlos Giraldo, Marta Prades, Jorge U. Carmona
    Cytokine.2017; 97: 149.     CrossRef
  • Rejeneratif Pulpa Tedavilerine Genel Bir Bakış
    Elif Sungurtekin Ekçi
    Cumhuriyet Dental Journal.2017; 19(3): 238.     CrossRef
  • Three-dimensional structure and cytokine distribution of platelet-rich fibrin
    Meng-Yi Bai, Ching-Wei Wang, Jyun-Yi Wang, Ming-Fang Lin, Wing P Chan
    Clinics.2017; 72(2): 116.     CrossRef
  • The impact of autologous platelet concentrates on endodontic healing: a systematic review
    Nastaran Meschi, Ana B. Castro, Katleen Vandamme, Marc Quirynen, Paul Lambrechts
    Platelets.2016; 27(7): 613.     CrossRef
  • Platelet concentrates for revitalization of immature necrotic teeth: a systematic review of the clinical studies
    Alessandra Lolato, Cristina Bucchi, Silvio Taschieri, Ahmed El Kabbaney, Massimo Del Fabbro
    Platelets.2016; 27(5): 383.     CrossRef
  • Endodontie in der unreifen bleibenden Dentition — Maßnahmen zur Vitalerhaltung, Apexifikation und Regeneration der Pulpa
    Martin Jung
    Oralprophylaxe & Kinderzahnheilkunde.2016; 38(1): 29.     CrossRef
  • A review of the regenerative endodontic treatment procedure
    Bin-Na Lee, Jong-Wook Moon, Hoon-Sang Chang, In-Nam Hwang, Won-Mann Oh, Yun-Chan Hwang
    Restorative Dentistry & Endodontics.2015; 40(3): 179.     CrossRef
  • Platelet preparations in dentistry: How? Why? Where? When?
    Luigi Fabrizio Rodella
    World Journal of Stomatology.2015; 4(2): 39.     CrossRef
  • The use of platelet rich plasma in the treatment of immature tooth with periapical lesion: a case report
    Günseli Güven Polat, Ceren Yıldırım, Özlem Martı Akgün, Ceyhan Altun, Didem Dinçer, Cansel Köse Özkan
    Restorative Dentistry & Endodontics.2014; 39(3): 230.     CrossRef
  • 300 View
  • 4 Download
  • 35 Crossref
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