scholarly journals Minireview of the clinical efficacy of platelet-rich plasma, platelet-rich fibrin and blood-clot revascularization for the regeneration of immature permanent teeth

2018 ◽  
Vol 6 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Peter E Murray
2021 ◽  
Vol 14 (3) ◽  
pp. e240203
Author(s):  
Arun Mayya ◽  
Shruti Bhandary ◽  
Advith Kolakemar ◽  
Ann Mary George

The management of necrotic immature permanent teeth has always been a challenge to endodontists. Various treatment modalities have been tried and tested for achieving a successful outcome. Revascularisation is one among these treatment options, which is gaining widespread attention among endodontists. The growing body of evidence demonstrating the success of revascularisation has led to different variations of this treatment option. Clinicians have over time used different scaffolds such as blood clot, collagen, platelet-rich fibrin (PRF) and platelet-rich plasma for revascularisation. This case report outlines the management of immature maxillary central incisors with pulp necrosis and large periapical lesions in a 19-year-old female patient with a modified technique of revascularisation by combining PRF and blood clot. At the end of 12 months, the patient was completely asymptomatic along with regression of the periapical lesions.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Sohaib Arshad ◽  
Fatima Tehreem ◽  
Muhammad Rehab khan ◽  
Fatima Ahmed ◽  
Anand Marya ◽  
...  

Regenerative endodontics has introduced numerous procedures such as pulp implantation, revascularization, and postnatal stem cell therapy. Revascularization has been successfully implemented clinically nowadays, thus providing dentists with outrageous results. Platelet-rich fibrin (PRF) used either alone or along with bone graft promotes bone growth and vascularization. This matrix promotes migration, cell attachment, and proliferation of osteoblast that leads to bone formation. PRF consists of a packed fibrin complex consisting of leukocytes, cytokines, and glycoproteins such as thrombospondin. The usage of PRF has reported high success rates in surgical cases such as sinus lift procedures, healing of extraction sockets, and management of periapical abscesses. Compared to platelet-rich plasma, PRF is more economical, easy to prepare, and feasible to use in daily clinical practices. Revascularization compromised the induction of a blood clot into the root canal space, which emerged as a clinical triumph. This further led to platelet concentrates as an autologous scaffold on which revascularization could occur. The applications of PRF in regenerative endodontics are numerous, such as an agent for repairing iatrogenic perforation of the pulpal floor and for the revascularization of immature permanent teeth with necrotic pulps. It acts as a matrix for tissue ingrowth. Evidence of progressive thickening of dentinal walls, root lengthening, regression in the periapical lesion, and apical closure was reported. Further studies are needed to clarify the precise mechanism of action of PRF for dental pulp regeneration both in vitro and in vivo. The current review aims at the present uses of PRF in regenerative endodontics dentistry and its application with future recommendations and limitations.


Author(s):  
Amna Riaz ◽  
Furqan A. Shah

Background: Autologous platelet concentrates such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have gained overwhelming popularity in regenerative endodontics. Clinical evidence reveals the lack of a particular advantage of using PRP or PRF over an evoked blood clot in promoting canal wall thickening and/or continued root development in immature necrotic teeth. Moreover, despite stimulating tissue repair and repopulating the root canals of immature and mature permanent teeth, the new vital tissue may not possess the functional activity of the native pulp tissue. Methods: To better understand the origin, nature, and long-term fate of the tissue types found within the pulp space, we critically examine all available histo-/morphological evidence for pulp–dentine complex regeneration using PRP and/or PRF, alone or together with an evoked blood clot, specialised or unspecialised primary cells, and other biomaterials. Results: Histological data from clinical studies is scant. Reportedly, the inner dentinal surface supports cementum-like tissue formation, but this interface likely deviates in structure and function from the native cementodentinal junction. Presence of bone-like tissue within the pulp space is intriguing since de novo osteogenesis requires closely coordinated recruitment and differentiation of osteoprogenitor cells. Compared to untreated necrotic teeth, an evoked blood clot (with/without PRF) improves fracture resistance. Tooth regeneration using PRF and dental bud cells is unreliable and the constituent neoformed tissues are poorly organised. Conclusion: PRP/PRF fail to demonstrate a significant advantage over an induced blood clot, alone. The true nature of neoformed tissues remains poorly characterised while their response to subsequent insult/injury is unexplored.


2021 ◽  
Vol 13 (13) ◽  
pp. 205-209
Author(s):  
Suvarna Sunder J ◽  
Seema Abid Hussain ◽  
Ullah Tareen Sabahat ◽  
Mahin Syed Ismail Prabu ◽  
Shetty Akhil ◽  
...  

2017 ◽  
Vol 45 (2) ◽  
pp. 583-593 ◽  
Author(s):  
Adel Alagl ◽  
Sumit Bedi ◽  
Khalid Hassan ◽  
Jehan AlHumaid

Objective This study was performed to assess the clinical and radiological outcomes of a revascularization procedure in immature teeth with apical periodontitis using platelet-rich plasma (PRP). The PRP protocol and conventional revascularization protocol, which used a blood clot as the scaffold, were compared. Methods Thirty non-vital immature permanent teeth were randomly categorized into two groups. After disinfecting the root canal space with triple antibiotic paste (1:1:1 ciprofloxacin, metronidazole, and cefaclor), a tissue scaffold was created using either PRP or a blood clot (control) and covered with white mineral trioxide aggregate. All cases were followed up clinically and radiographically for 12 months. Differences in bone density, root length, and lesion size were calculated using preoperative and postoperative computed tomography images. The means of the differences in individual parameters in the blood clot and PRP groups were compared using the Mann–Whitney U test. Results After 5 months, sensitivity tests (cold and electric pulp tests) elicited a delayed positive response in 23 sites. At 12 months, cone-beam computed tomography revealed resolution or a decrease in lesion size and an increase in bone density in all 30 (100%) teeth. Additionally, continued root development was observed in 22 (73%) teeth and early root growth was observed in the test group (mineral trioxide aggregate with PRP). Conclusions The results of this study suggest that PRP can serve as a successful scaffold for regenerative endodontic treatment. With the exception of a significant increase in root length, the results of treatment with PRP were not significantly different from those of the conventional protocol using a blood clot as the scaffold.


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