Aim: The objective of the study was to assess the regenerative potential of advanced platelet-rich fibrin (APRF) in the regenerative treatment of necrotic immature permanent teeth (NIPT) in the maxillary incisor region. Study design: After institutional review board clearance, 10 children aged between 8 and 14 years with NIPT in the maxillary incisor region undergoing APRF treatment were enrolled in a prospective clinico-radiographic exploratory observational study. Baseline clinical, radiographic, and vitality testing before the start of treatment were noted. Patients were followed up at 3, 6, and 12 months posttreatment. Results: After 3, 6, and 12 months of follow-up, all patients (100%) showed complete resolution of clinical signs and symptoms. All patients (100%) showed periradicular healing, and 9 out of 10 patients (90%) showed a clear hard tissue bridge formation at various levels in the root canal on postoperative radiographs. None of the patients (0%) showed a positive response to vitality testing. Conclusion: APRF is a promising biomaterial in regenerative endodontic treatment (RET). Future randomized trials can be planned to establish superiority or equivalence to conventional PRF.
Kim SG, Malek M, Sigurdsson A, et al. Regenerative endodontics: a comprehensive review. Int Endod J 2018;51(12):1367–1388. DOI: 10.1111/iej.12954
Hotwani K, Sharma K. Platelet rich fibrin - a novel acumen into regenerative endodontic therapy. Restor Dent Endod 2014;39(1):1–6. DOI: 10.5395/rde.2014.39.1.1
Murray PE, Garcia-Godoy F, Hargreaves KM. Regenerative endodontics: a review of current status and a call for action. J Endod 2007;33(4):377–390. DOI: 10.1016/j.joen.2006.09.013
Chisini LA, Grazioli G, Francia A, et al. Revascularization versus apical barrier technique with mineral trioxide aggregate plug: a systematic review. Giornaleitaliano di endodonzia 2018;32(1):9–16. DOI: 10.1016/j.gien.2018.03.006
Santhakumar M, Yayathi S, Retnakumari N. A clinicoradiographic comparison of the effects of platelet-rich fibrin gel and platelet-rich fibrin membrane as scaffolds in the apexification treatment of young permanent teeth. J Indian Soc Pedod Prev Dent 2018;36(1):65–70. DOI: 10.4103/JISPPD.JISPPD_180_17
Choukroun J, Ghanaati S. Reduction of relative centrifugation force within injectable platelet-rich-fibrin (PRF) concentrates advances patients’ own inflammatory cells, platelets and growth factors: the first introduction to the low speed centrifugation concept. Eur J Trauma Emerg Surg 2018;44(1):87–95. DOI: 10.1007/s00068-017-0767-9
Current considerations for regenerative procedures. American Association of Endodontists, (AAE) 2018
Keswani D, Pandey RK. Revascularization of an immature tooth with a necrotic pulp using platelet-rich fibrin: a case report. Int Endod J 2013;46(11):1096–1104. DOI: 10.1111/iej.12107
Sharma S, Mittal N. A comparative evaluation of natural and artificial scaffolds in regenerative endodontics: a clinical study. Saudi Endod J 2016;6(1):9–15. DOI: 10.4103/1658-5984.171995
Choukroun J. Advanced PRF& i-PRF: platelet concentrates or blood concentrates. J Periodontal Med Clin Pract 2014;1(1):3.
Gordon S. Alternative activation of macrophages. Nat Rev Immunol 2003;3(1):23–35. DOI: 10.1038/nri978
Shah R, M GT, Thomas R, et al. An update on the protocols and biologic actions of platelet rich fibrin in dentistry. Eur J Prosthodont Restor Dent 2017;25:64–72. DOI: 10.1922/EJPRD_01690Shah09
Rajasekharan S, Martens LC, Cauwels RG, et al. Biodentine™ material characteristics and clinical applications: a review of the literature. Eur Arch Paediatr Dent 2014;15(3):147–158. DOI: 10.1007/s40368-014-0114-3
Prabhakar AR, Rani NS, Yavagal C. Revascularization of immature necrotic teeth with platelet-rich fibrin and blood clot. Int J Oral Health Sci 2016;6(1):4–10. DOI: 10.4103/2231-6027.186657
Lolato A, Bucchi C, Taschieri S, et al. Platelet concentrates for revitalization of immature necrotic teeth: a systematic review of the clinical studies. Platelets 2016;27(5):383–392. DOI: 10.3109/09537104.2015.1131255
Chen MY, Chen KL, Chen CA, et al. Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures. Int Endod J 2012;45(3):294–305. DOI: 10.1111/j.1365-2591.2011.01978.x
Prasad J, de Ataide IN, Chalakkal P, et al. Comparison between the outcomes of two platelet-rich concentrates on apexogenesis in young permanent incisors requiring endodontic retreatment. Contemp Clin Dent 2018;9(Suppl 1):S156–S159. DOI: 10.4103/ccd.ccd_9_18
Duncan, Henry, Cooper, et al. Clinical approaches in endodontic regeneration current and emerging therapeutic perspectives. Springer; 2019;189.
Wang X, Thibodeau B, Trope M, et al. Histologic characterization of regenerated tissues in canal space after the revitalization/revascularization procedure of immature dog teeth with apical periodontitis. J Endod 2010;36(1):56–63. DOI: 10.1016/j.joen.2009.09.039
Lv H, Chen Y, Cai Z, et al. The efficacy of platelet-rich fibrin as a scaffold in regenerative endodontic treatment: a retrospective controlled cohort study. BMC Oral Health 2018;18(1):139. DOI: 10.1186/s12903-018-0598-z
Lei L, Chen Y, Zhou R, et al. Histologic and immunohistochemical findings of a human immature permanent tooth with apical periodontitis after regenerative endodontic treatment. J Endod 2015;41(7):1172–1179. DOI: 10.1016/j.joen.2015.03.012
Shivashankar VY, Johns DA, Vidyanath S, et al. Platelet rich fibrin in the revitalization of tooth with necrotic pulp and open apex. J Conserv Dent 2012;15(4):395–398. DOI: 10.4103/0972-0707.101926
