Jayadevan Veena, Gehlot Paras-Mull, Manjunath Vinutha, Madhunapantula Subbarao V, Lakshmikanth Jyothi-Swandenahalli
BDS. Department of Conservative Dentistry and Endodontics. JSS Dental College and Hospital. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India.
MDS. Department of Conservative Dentistry and Endodontics. JSS Dental College and Hospital. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India.
J Clin Exp Dent. 2021 May 1;13(5):e463-e472. doi: 10.4317/jced.57902. eCollection 2021 May.
Regenerative endodontic treatment (RET) is a promising treatment alternative for traumatized immature non-vital teeth. Advanced platelet-rich fibrin (A-PRF) contains significantly more growth factors than Platelet-rich fibrin (PRF) and has not been evaluated as a scaffold in RET. The aim of the present study was to evaluate and compare A-PRF and PRF as scaffolds in the RET concerning periapical healing, and root development of traumatized immature non-vital teeth.
In the present study, RET was performed on 30 traumatized immature non-vital maxillary incisors in 28 patients aged between 8-27 years. Minimal mechanical debridement and irrigation with 1.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid was performed. Canals were disinfected using modified triple antibiotic paste consisting of ciprofloxacin, metronidazole and cefaclor. Based on the type of scaffold, teeth were randomly assigned into A-PRF (n=15) and PRF groups (n=15). Periapical healing, apical response and quantitative root dimensions (length and thickness) were analyzed radiographically after 12 months follow-up.
Nineteen patients with 21 teeth (A-PRF n=11, PRF n=10) completed the follow-up and 9 patients were excluded. Clinically, patients in both the groups were asymptomatic. The survival rates for A-PRF and PRF were 78.5% and 77.5%, respectively. No statistically significant differences were detected between A-PRF and PRF regarding periapical healing and type of apical response (& 0.05). The difference in the pre-operative and follow-up root thickness and root length in both A-PRF and PRF groups were statistically significant (< 0.05).
Based on short-term results of 13 months, both A-PRF and PRF can be used as scaffold in regenerative endodontic treatment of traumatized immature non-vital teeth. A-PRF could be recommended in such cases since it yielded more root dentin thickness which is crucial for reinforcing immature teeth. Regenerative endodontic treatment, dental trauma, Non-vital teeth, immature teeth, platelet-rich fibrin, advanced platelet-rich fibrin.
再生性牙髓治疗（RET）是治疗外伤后未成熟恒牙的一种有前景的替代治疗方法。高级富血小板纤维蛋白（A-PRF）比富血小板纤维蛋白（PRF）含有更多的生长因子，且尚未作为再生性牙髓治疗中的支架材料进行评估。本研究的目的是评估和比较A-PRF和PRF作为支架材料在再生性牙髓治疗中对根尖周愈合及外伤后未成熟恒牙牙根发育的影响。
本研究对28例年龄在8至27岁之间的患者的30颗外伤后未成熟恒牙进行了再生性牙髓治疗。进行了最小限度的机械清创，并用1.5%次氯酸钠和17%乙二胺四乙酸进行冲洗。使用由环丙沙星、甲硝唑和头孢克洛组成的改良三联抗生素糊剂对根管进行消毒。根据支架材料类型，将牙齿随机分为A-PRF组（n = 15）和PRF组（n = 15）。随访12个月后，通过影像学分析根尖周愈合、根尖反应及定量牙根尺寸（长度和厚度）。
19例患者的21颗牙齿（A-PRF组n = 11，PRF组n = 10）完成了随访，9例患者被排除。临床上，两组患者均无症状。A-PRF组和PRF组的生存率分别为78.5%和77.5%。在根尖周愈合和根尖反应类型方面，A-PRF组和PRF组之间未检测到统计学显著差异（P > 0.05）。A-PRF组和PRF组术前与随访后的牙根厚度和牙根长度差异均具有统计学意义（P < 0.05）。
基于13个月的短期结果，A-PRF和PRF均可作为外伤后未成熟恒牙再生性牙髓治疗的支架材料。鉴于A-PRF能产生更多对加固未成熟牙齿至关重要的牙根牙本质厚度，在这类病例中可推荐使用A-PRF。再生性牙髓治疗、牙外伤、无活力牙、未成熟牙、富血小板纤维蛋白、高级富血小板纤维蛋白
