Saeed, M., Ibrahim, M., Moussa, S., Leheta, N. (2021). PLATELET RICH FIBRIN SCAFFOLD COMBINED WITH INDUCED BLOOD CLOT IN PULP REVASCULARIZATION OF NECROTIC IMMATURE PERMANENT TEETH WITH CHRONIC PERIAPICAL LESIONS: A CASE SERIES. Alexandria Dental Journal, 46(3), 117-122. doi: 10.21608/adjalexu.2020.37448.1091
Mahmoud M Saeed; Mohamed M Ibrahim; Sybele M Moussa; Nihal A Leheta. "PLATELET RICH FIBRIN SCAFFOLD COMBINED WITH INDUCED BLOOD CLOT IN PULP REVASCULARIZATION OF NECROTIC IMMATURE PERMANENT TEETH WITH CHRONIC PERIAPICAL LESIONS: A CASE SERIES". Alexandria Dental Journal, 46, 3, 2021, 117-122. doi: 10.21608/adjalexu.2020.37448.1091
Saeed, M., Ibrahim, M., Moussa, S., Leheta, N. (2021). 'PLATELET RICH FIBRIN SCAFFOLD COMBINED WITH INDUCED BLOOD CLOT IN PULP REVASCULARIZATION OF NECROTIC IMMATURE PERMANENT TEETH WITH CHRONIC PERIAPICAL LESIONS: A CASE SERIES', Alexandria Dental Journal, 46(3), pp. 117-122. doi: 10.21608/adjalexu.2020.37448.1091
Saeed, M., Ibrahim, M., Moussa, S., Leheta, N. PLATELET RICH FIBRIN SCAFFOLD COMBINED WITH INDUCED BLOOD CLOT IN PULP REVASCULARIZATION OF NECROTIC IMMATURE PERMANENT TEETH WITH CHRONIC PERIAPICAL LESIONS: A CASE SERIES. Alexandria Dental Journal, 2021; 46(3): 117-122. doi: 10.21608/adjalexu.2020.37448.1091
PLATELET RICH FIBRIN SCAFFOLD COMBINED WITH INDUCED BLOOD CLOT IN PULP REVASCULARIZATION OF NECROTIC IMMATURE PERMANENT TEETH WITH CHRONIC PERIAPICAL LESIONS: A CASE SERIES
1PhD candidate at the Endodontic Department, Faculty of Dentistry, Alexandria University, Egypt.
2Professor of Endodontics, Faculty of Dentistry, Alexandria University, Egypt
3Professor of Endodontics, Faculty of Dentistry, Alexandria University, Egypt.
4Lecturer of Endodontics, Faculty of Dentistry, Alexandria University, Egypt.
Abstract
ABSTRACT Background: Traumatized non-vital permanent teeth with incomplete root formation and divergent apices present particular challenges to clinicians during management with traditional approaches. Objectives: This report described the outcomes of pulp revascularization of three traumatized immature necrotic permanent teeth using platelet-rich fibrin scaffold combined with induced blood clot. Materials and Methods: Three patients (two boys aged 8 and 11 years and one girl aged 13 years) were presented with immature maxillary incisors with necrotic pulps. Access cavities were prepared and the root canals were gently irrigated with 1.5% sodium hypochlorite (20 mL/ 5 min). Calcium hydroxide paste was applied three mm short of the root apex and the canals were temporized with intermediate restorative material. At the following appointment after two weeks, the teeth were treated by revascularization protocol using Platelet rich fibrin scaffold combined with induced blood clot and the three cases were clinically and radiographically followed up to eighteen months. Results: The patients were clinically asymptomatic at all follow-up periods. Cone Beam Computed Tomography (CBCT) images revealed evidence of root maturation and healing of the periapical lesions. Calcific intra-canal deposits were noted at the middle and apical thirds of the root canals. Conclusions: Pulp revascularization procedure using Platelet rich fibrin scaffold showed evidence of root elongation, increased dentin thickness and resolution of the periapical lesions.
Bakhtiar H, Esmaeili S, Fakhr Tabatabayi S, Ellini MR, Nekoofar MH, Dummer PM. Second-generation platelet concentrate (platelet–rich fibrin) as a scaffold in regenerative endodontics: a case series. J Endod. 2017;43:401- 8.
Yassen GH, Eckert GJ, Platt JA. Effect of intracanal medicaments used in endodontic regeneration procedures on microhardness and chemical structure of dentin. Restor Dent Endod. 2015;40:104-12.
Mente J, Hage N, Pfefferle T, Koch MJ, Dreyhaupt J, Staehle HJ, et al. Mineral trioxide aggregate apical plugs in teeth with open apical foramina: a retrospective analysis of treatment outcome. J Endod. 2009;35:1354-8.
Cvek M. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-
percha: a retrospective clinical study. Endod Dent Traumatol. 1992;8:45-55.
Demarco FF, Casagrande L, Zhang Z, Dong Z, Tarquinio SB, Zeitlin BD, et al. Effects of morphogen and
scaffold porogen on the differentiation of dental pulp stem cells. J Endod. 2010;36:1805-11.
Hargreaves KM, Giesler T, Henry M, Wang Y. Regeneration potential of the young permanent tooth: what does
the future hold? J Endod. 2008;34:51-6 .
Mehta S, Watson JT. Platelet rich concentrate: basic science and current clinical applications. J Orthop Trauma.
2008;22:432-8.
8.
9.
Chen YJ, Zhao YH, Zhao YJ, Liu NX, Lv X, Li Q, et al. Potential dental pulp revascularization and odonto- /osteogenic capacity of a novel transplant combined with dental pulp stem cells and platelet-rich fibrin. Cell Tissue Res. 2015;361:439-55.
Kim SG, Malek M, Sigurdsson A, Lin LM, Kahler B. Regenerative endodontics: A comprehensive review. Int Endod J. 2018;51:1367-88.
Chen MY, Chen KL, Chen CA, Tayebaty F, Rosenberg PA, Lin LM. Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures. Int Endod J. 2012;45:294-305.
Song M, Cao Y, Shin SJ, Shon WJ, Chugal N, Kim RH, et al. Revascularization-associated intracanal calcification: assessment of prevalence and contributing factors. J Endod. 2017;43:2025-33.
KahlerB,MistryS,MouleA,RingsmuthAK,CaseP,ThomsonA,etal.Revascularizationoutcomes:aprospective analysis of 16 consecutive cases. J Endod. 2014;40:333-8.
Law AS. Considerations for regeneration procedures. J Endod. 2013;39(3 Suppl):S44-56.
Keswani D, Pandey RK. Revascularization of an immature tooth with a necrotic pulp using platelet-rich fibrin:
a case report. Int Endod J. 2013;46:1096-104.
Petrino JA, Boda KK, Shambarger S, Bowles WR, McClanahan SB. Challenges in regenerative endodontics: a
case series. J Endod. 2010;36:536-41.
Piva E, Silva AF, Nör JE. Functionalized scaffolds to control dental pulp stem cell fate. J Endod. 2014;40:S33-
40.
Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, et al. Platelet-rich fibrin (PRF): a
second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol
Oral Radiol Endod. 2006;101:e56-60.
Alkahtani A, Alkahtany SM, Anil S. An in vitro evaluation of the cytotoxicity of varying concentrations of
sodium hypochlorite on human mesenchymal stem cells. J Contemp Dent Pract. 2014;15:473-81.
Casagrande L, Demarco FF, Zhang Z, Araujo FB, Shi S, Nör JE. Dentin-derived BMP-2 and odontoblast
differentiation. J Dent Res. 2010;89:603-8.
Smith AJ, Duncan HF, Diogenes A, Simon S, Cooper PR. Exploiting the bioactive properties of the dentin-pulp
complex in regenerative endodontics. J Endod. 2016;42:47-56.
Linsuwanont P, Sinpitaksakul P, Lertsakchai T. Evaluation of root maturation after revitalization in immature
permanent teeth with nonvital pulps by cone beam computed tomography and conventional radiographs. Int
Endod J. 2017;50:836-46.
24.
Murray PE. 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.
Front Bioeng Biotechnol. 2018;6:139.
ElSheshtawy AS, Nazzal H, El Shahawy OI, El Baz AA, Ismail SM, Kang J, Ezzat KM. 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. Int Endod J.
2020;53:905-21.
Kandemir Demirci G, Güneri P, Çalışkan MK. Regenerative Endodontic Therapy with Platelet Rich Fibrin: Case
Series. J Clin Pediatr Dent. 2020;44:15-9.
WangX,ThibodeauB,TropeM,LinLM,HuangGT.Histologiccharacterizationofregeneratedtissuesincanal space after the revitalization/revascularization procedure of immature dog teeth with apical periodontitis. J Endod. 2010;36:56-63 .
Martin G, Ricucci D, Gibbs JL, Lin LM. Histological findings of revascularized/revitalized immature permanent molar with apical periodontitis using platelet-rich plasma. J Endod. 2013;39:138-44.
Diogenes A, Ruparel NB, Shiloah Y, Hargreaves KM. Regenerative endodontics: A way forward. J Am Dent Assoc. 2016;147:372-80.
Nosrat A, Homayounfar N, Oloomi K. Drawbacks and unfavorable outcomes of regenerative endodontic treatments of necrotic immature teeth: a literature review and report of a case. J Endod. 2012;38:1428-34.