School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China; Key Laboratory of Stomatology, Fujian Medical University, Fujian Province University, Fuzhou, China.
Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou, China.
J Endod. 2017 Dec;43(12):2034-2040. doi: 10.1016/j.joen.2017.07.021. Epub 2017 Oct 9.
No in vivo study has been reported on the mechanical reinforcement of a tooth after regenerative endodontic treatment (RET). The present work aimed to evaluate the concurrent use of platelet-rich fibrin (PRF) with a blood clot (BC) in RET concerning periapical healing, root development, and tooth structural reinforcement.
In our study, 24 premolars from 3 beagle dogs were assigned into control, BC, and PRF + BC groups. Periapical healing was monitored with quantitative measurements of root elongation and thickening radiographically. Tooth biomechanical integrity was assessed with the fracture resistance test. Histologic evaluation was conducted.
There was a significant difference among the periapical radiolucency decreasing rate of the control (43.75%) and the BC (100%) and PRF + BC (100%) groups (P < .05). The increase of root length and thickness in both the BC and PRF + BC groups was significantly greater than that in the control group (P < .05). No significant difference was detected between the 2 experimental groups regarding periapical healing or root development (P > .05). Teeth in the BC (249.3 ± 64.1 N) and PRF + BC (281.7 ± 37.8 N) groups had significantly higher fracture resistance than those in the control group (108.5 ± 23.3 N) (P < .05). No significant difference was revealed between the BC and PRF + BC groups (P > .05). Histologic evidence of cementumlike tissue deposition along the canal wall with scattered bonelike tissue in the canal was observed.
Either a combination of PRF with BC or BC alone could improve periapical healing, induce root development, and reinforce tooth structure. No additional benefit of PRF to BC in RET was found.
再生性根管治疗（RET）后，尚未有关于牙齿机械强化的体内研究报告。本研究旨在评估富血小板纤维蛋白（PRF）与血凝块（BC）联合应用于 RET 后，对根尖愈合、牙根发育和牙齿结构强化的影响。
本研究共纳入 3 只比格犬的 24 颗前磨牙，分为对照组、BC 组和 PRF+BC 组。通过根尖周组织放射学测量根伸长和增宽来监测根尖愈合情况。采用抗折强度试验评估牙齿生物力学完整性。行组织学评价。
对照组（43.75%）和 BC 组（100%）、PRF+BC 组（100%）的根尖周放射透亮区减少率差异有统计学意义（P<.05）。BC 组和 PRF+BC 组的牙根长度和厚度增加均显著大于对照组（P<.05）。两组在根尖愈合和牙根发育方面差异无统计学意义（P>.05）。BC 组（249.3±64.1 N）和 PRF+BC 组（281.7±37.8 N）的牙齿抗折强度明显高于对照组（108.5±23.3 N）（P<.05）。BC 组与 PRF+BC 组之间差异无统计学意义（P>.05）。组织学观察到沿根管壁有类牙骨质样组织沉积，管腔内有散在的骨样组织。
PRF 联合 BC 或单独使用 BC 均可促进根尖愈合、诱导牙根发育并增强牙齿结构。PRF 对 RET 中 BC 无额外益处。
