Restorative Dentistry & Endodontics

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

Abstract PDF Supplementary Material PubReader ePub: 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.

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Management of apicomarginal defect in esthetic region associated with a tooth with anomalies: Vinayak Venkoosa Meharwade, Dipali Yogesh Shah, Pradyna Prabhakar Mali, Vidya Vinayak Meharwade; Restor Dent Endod 2015;40(4):314-321. Published online June 24, 2015; DOI: https://doi.org/10.5395/rde.2015.40.4.314

Abstract PDF PubReader ePub: Tooth related factors such as palatoradicular groove can be one of the causes for localized periodontal destruction. Such pathological process may result in apicomarginal defect along with inflammation of pulp. This creates challenging situation which clinician must be capable of performing advanced periodontal regenerative procedures for the successful management. This case report discusses clinical management of apicomarginal defect associated with extensive periradicular destruction in a maxillary lateral incisor, along with histopathologic aspect of the lesion.

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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; Restor Dent Endod 2014;39(3):230-234. Published online June 2, 2014; DOI: https://doi.org/10.5395/rde.2014.39.3.230

Abstract PDF PubReader ePub: This study describes the treatment of an immature permanent tooth with periapical lesion which was treated with regenerative approach using platelet rich plasma (PRP). The root canal of immature human permanent tooth with periapical lesion was gently debrided of necrotic tissue and disinfected with 2.5% NaOCl, and then medicated with triple antibiotic paste comprised of ciprofloxacin, metronidazole, and tetracycline. When the tooth was asymptomatic, PRP and mineral trioxide aggregate (MTA) were placed into the root canal. Six months after PRP treatment, radiographical examination revealed resolution of the radiolucency and progressive thickening of the root wall and apical closure. Our findings suggest that PRP can be used for the treatment of immature permanent teeth with periapical lesion, as part of a regenerative endodontic treatment procedure.

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