Department of Endodontics, School of Dentistry, Londa Linda University, Loma Linda, California 92350, USA.
J Endod. 2012 Jun;38(6):864-8. doi: 10.1016/j.joen.2012.03.006.
In patients, the outcomes of teeth with necrotic pulps and open apexes that have been treated with regenerative endodontics have always been evaluated clinically and radiographically. The purpose of this case report is to present the clinical, radiographic, and histological findings of a regenerative procedure using platelet-rich plasma (PRP) 14 months after the procedure.
A 12-year-old boy whose maxillary second premolar tooth had been treated with regenerative endodontics was seen with a chief complaint of pain and sensitivity to cold. After clinical and radiographic examinations, a pulpal diagnosis of reversible pulpitis and normal periapical tissues was made for this tooth. Because of the patient's complaint and his guardian's insistence on either a root canal treatment or an extraction, a root canal treatment was performed in this tooth. After entry into the root canal, the soft tissue present in the canal was removed with the aid of a large barbed broach and examined histologically.
Examination of the tissue removed from the root canal of this tooth revealed the presence of a vital pulp-like vital connective tissue. There was no evidence of bone in the specimen. Very few inflammatory cells were noted in the periphery of the specimen.
Based on these findings, it appears that pulp-like tissue can be generated in a human tooth with the use of PRP as a scaffold in regenerative endodontic procedures.
在患者中，经过再生性内科学治疗的坏死牙髓和开放根尖的牙齿的治疗结果一直以来都是通过临床和影像学进行评估的。本病例报告的目的是介绍在治疗后 14 个月使用富含血小板的血浆（PRP）进行再生程序的临床、放射影像学和组织学发现。
一名 12 岁男孩，其上颌第二前磨牙曾接受过再生性内科学治疗，主诉有疼痛和对冷敏感的症状。经过临床和放射影像学检查，该牙被诊断为可逆性牙髓炎和正常根尖周组织。由于患者的抱怨和其监护人对根管治疗或拔牙的坚持，这颗牙进行了根管治疗。在进入根管后，使用大倒刺锉去除管内的软组织，并进行组织学检查。
对这颗牙根管内取出的组织进行检查，发现存在类似于活髓的有活力的结缔组织。标本中没有骨的证据。在标本的外围只注意到很少的炎症细胞。
根据这些发现，似乎可以在人类牙齿中使用 PRP 作为支架，在再生性内科学治疗中生成类似牙髓的组织。
