Platelet-rich fibrin and collagen matrix for the regeneration of infected necrotic immature teeth

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Abstract

Revitalization of a necrotic immature tooth is possible under conditions of total canal disinfection. This case report describes an immature tooth #21 with periapical pathology which was treated through revascularization using 3% sodium hypochlorite and 17% ethylenediaminetetraacetic acid as irrigants; Calcium hydroxide was placed as an intracanal medicament, platelet-rich fibrin as scaffold and collagen matrix was placed as a barrier. On follow-up at 2 years, healing of periapical lesion, apical closure could be appreciated. Based on the results, we conclude that regeneration of necrotic tooth is possible under efficient disinfection.

Relevance for patients: This article documents the 2-year outcome of regenerative endodontic treatment in necrotic immature teeth. The successful outcome of this case shows that regenerative endodontic teeth can be a viable treatment option in immature teeth.

Keywords

collagen matrix

mineral trioxide aggregate

platelet-rich fibrin

regeneration

References

1. Mohammadi Z, Dummer PM. Properties and Applications of Calcium Hydroxide in Endodontics and Dental Traumatology. Int Endod J 2011;44:697-730.

2. Murray PE, Garcia-Godoy F, Hargreaves KM. Regenerative Endodontics: A Review of Current Status and a Call for Action. J Endod 2007;33:377-90.

3. Kang J, Fan W, Deng Q, He H, Huang F. Stem Cells from the Apical Papilla: A Promising Source for Stem CellBased Therapy. Biomed Res Int 2019;2019:6104738.

4. Bansal R, Jain A, Mittal S. Current Overview on Challenges in Regenerative Endodontics. J Conserv Dent 2015;18:1-6.

5. Pina S, Ribeiro VP, Marques CF, Maia FR, Silva TH, Reis RL, et al. Scaffolding Strategies for Tissue Engineering and Regenerative Medicine Applications. Materials (Basel) 2019;12:1824.

6. Torabinejad M, Nosrat A, Verma P, Udochukwu O. Regenerative Endodontic Treatment or Mineral Trioxide Aggregate apical Plug in Teeth with Necrotic Pulps and Open Apices: A Systematic Review and Meta-Analysis. J Endod 2017;43:1806-20.

7. Diogenes A, Ruparel NB, Shiloah Y, Hargreaves KM. Regenerative Endodontics: A Way Forward. J Am Dent Assoc 2016;147:372-80.

8. Lin LM, Kahler B. A Review of Regenerative Endodontics: Current Protocols and Future Directions. J Istanb Univ Fac Dent 2017;51 Suppl 1:S41-51.

9. Nada OA, El Backly RM. Stem Cells from the Apical Papilla (SCAP) as a Tool for Endogenous Tissue Regeneration. Front Bioeng Biotechnol 2018;6:103.

10. Tomokiyo A, Yoshida S, Hamano S, Hasegawa D, Sugii H, Maeda H, et al. Detection, Characterization, and Clinical Application of Mesenchymal Stem Cells in Periodontal Ligament Tissue. Stem Cells Int 2018;2018:5450768.

11. Narang I, Mittal N, Mishra N. A Comparative Evaluation of the Blood Clot, Platelet-Rich Plasma, and Platelet-Rich Fibrin in Regeneration of Necrotic Immature Permanent Teeth: A Clinical Study. Contemp Clin Dent 2015;6:63-8.

12. Chai J, Jin R, Yuan G. Effect of Liquid Platelet-Rich Fibrin and Platelet-Rich Plasma on the Regenerative Potential of Dental Pulp Cells Cultured Under Inflammatory Conditions: A Comparative Analysis. J Endod 2019;45:1000-8.

13. Ulusoy AT, Turedi I, Cimen M, Cehreli ZC. Evaluation of Blood Clot, Platelet-Rich Plasma, Platelet-Rich Fibrin, and Platelet Pellet as Scaffolds in Regenerative Endodontic Treatment: A Prospective Randomized Trial. J Endod 2019;45:560-6.

14. Miron RJ, Zucchelli G, Pikos MA, Salama M, Lee S, Guillemette V, et al. Use of Platelet-Rich Fibrin in Regenerative Dentistry: A Systematic Review. Clin Oral Investig 2017;21:1913-27.

15. Kulan P, Karabiyik O, Kose GT, Kargul B. The Effect of Accelerated Mineral Trioxide Aggregate on Odontoblastic Differentiation in Dental Pulp Stem Cell Niches. Int Endod J 2018;51:758-66.

16. Nazzal H, Kenny K, Altimimi A, Kang J, Duggal MS. A Prospective Clinical Study of Regenerative Endodontic Treatment of Traumatized Immature Teeth with Necrotic Pulps Using Bi-Antibiotic Paste. Int Endod J 2018;51 Suppl 3:e204-15.

17. Li X, Yang H, Zhang Z, Yan Z, Lv H, Zhang Y, et al. Platelet-Rich Fibrin Exudate Promotes the Proliferation and Osteogenic Differentiation of Human Periodontal Ligament Cells In Vitro. Mol Med Rep 2018;18:4477-85.

18. Paryani K, Kim SG. Regenerative Endodontic Treatment of Permanent Teeth after Completion of Root Development: A Report of 2 Cases. J Endod 2013;39:929-34.

19. Suresh N, Arul B, Kowsky D, Natanasabapathy V. Successful Regenerative Endodontic Procedure of a Nonvital Immature Permanent Central Incisor Using Amniotic Membrane as a Novel Scaffold. Dent J (Basel) 2018;6:36.

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Journal of Clinical and Translational Research, Electronic ISSN: 2424-810X Print ISSN: 2382-6533, Published by AccScience Publishing