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Regenerative Endodontic Management of an Immature Necrotic Premolar Using Advanced Platelet-Rich Fibrin. Case Rep Dent 2023; 2023:1135413. [PMID: 36762288 PMCID: PMC9904919 DOI: 10.1155/2023/1135413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/16/2022] [Accepted: 01/19/2023] [Indexed: 02/04/2023] Open
Abstract
Regenerative endodontic management is a feasible treatment for immature teeth with periapical radiolucency and necrotic pulp that simplifies continued root creation. Among the most prevalent health problems in an immature root is dental pulp necrosis, which is caused by caries, improper endodontic treatments, and trauma. Necrosis of the dental pulp can affect long-term tooth survival and preservation and serve as a source of bacteria infecting the periapical tissue and the maxillofacial space. Here, we report on the application of advanced platelet-rich fibrin plus (A-PRF+) therapy, as a regenerative endodontic treatment (RET), in a 12-year-old with necrotic pulp and asymptomatic apical periodontitis. Over a 24-month follow-up post-treatment, we observed resolving of symptoms and a complete root formation with considerable periapical healing.
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Elkholly A, Negm M, Hassan R, Omar N. Healing Assessment of Osseous Defects after Surgical Removal of Periapical Lesions in the Presence of Hydroxyapatite, Nanohydroxyapatite, and a Combination of Nanohydroxyapatite and Platelet-rich Fibrin: A Clinical Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract:
Aim: to evaluate the bone healing in failed endodontically treated teeth after surgical removal of periapical lesions and placement of hydroxyapatite (HA), nanohydroxyapatite (nHA) and a combination of nanohydroxyapatite with platelet rich fibrin (PRF) periapically. Subjects and methods: the study was conducted on twenty-four patients having periapical radiolucency in single rooted teeth. The selected teeth were divided into three groups: Group A, Group B, and Group C; of 8 teeth each. All the teeth were retreated in two visits. In the first visit the old filling was removed using Protaper retreatment files (Dentsply Sirona®) then irrigation with sodium hypochlorite 2.5% was done. All canals were dried and filled with Di-antibiotic paste (metronidazole and ciprofloxacin). In the second visit the canals were obturated with Pro Taper gutta-percha points and root canal sealer (Adseal resin sealer) followed by surgical intervention in the same day. A periapical curettage along with apicoectomy were established. In all the groups, root end cavity was prepared and filled with MTA (ProRoot MTA; DENTSPLY Tulsa Dental Specialties). In Group A, hydroxyapatite powder was packed in the curetted periapical defect. In Group B, nanohydroxyapatite powder was packed in the curetted periapical defect. In Group C, nanohydroxyapatite with PRF were mixed and packed in the curetted periapical defect. In all groups, patients recall visits were scheduled at 1, 3, and 6 months’ time intervals for clinical and radiological evaluation. Results: after one month; there was a statistically significant difference between the median percentage changes in lesions size in the three groups. Pair-wise comparisons between groups revealed that there was no statistically significant difference between group B (nHA) and group C (PRF and nHA) groups. Both showed statistically significantly higher median percentage reduction in lesions size than group A (HA group). After three as well as six months; there was no statistically significant difference between the median percentage decreases in lesions size in the three groups. Conclusion: It was concluded that nHA combination with PRF produced faster periapical healing (bone regeneration) in the first three months than nHA alone. However, HA produce periapical healing (bone regeneration) after six months.
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Effect of biodentine coated with emdogain on proliferation and differentiation of human stem cells from the apical papilla. Mol Biol Rep 2022; 49:3685-3692. [PMID: 35107735 DOI: 10.1007/s11033-022-07208-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/26/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND This study assessed the effect of Biodentine coated with Emdogain (Biodentine/Emdogain) on proliferation and differentiation of human stem cells from the apical papilla (SCAPs). METHODS AND RESULTS: In this in vitro, experimental study, SCAPs were isolated from two immature impacted third molars and cultured. After ensuring the stemness of the cells by assessing the cell surface markers, they were exposed to Biodentine, Emdogain, and Biodentine/Emdogain for 24 and 72 h. The control cells did not receive any intervention. Cell viability was evaluated by the methyl thiazolyl tetrazolium assay. Expression of odontogenic differentiation genes was analyzed by the quantitative reverse transcription polymerase chain reaction. Alkaline phosphatase (ALP) activity was quantified by the respective kit. Data were analyzed by one-way ANOVA, t-test, and Mann-Whitney test (α = 0.05). Cell viability did not change after 24 h of exposure to biomaterials. At 72 h, the viability of the cells exposed to Biodentine and Biodentine/Emdogain decreased compared with the control group. The expression of dentin sialophosphoprotein, dentin matrix protein 1, and bone sialoprotein genes, and ALP activity significantly increased in all three experimental groups, compared with the control group at both 24 and 72 h; this increase was significantly greater in Biodentine/Emdogain group. The number of mineralized nodules significantly increased in all groups after 72 h with a greater rate in Biodentine/Emdogain group. CONCLUSIONS All biomaterials increased the differentiation of SCAPs, expression of odontogenic genes, and ALP activity, but Biodentine/Emdogain was significantly more effective for this purpose.
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Bansal M, Khatri M, Puri K. Case report on combining PRF with alloplastic bone substitute in Endo-Perio lesion. Restor Dent Endod 2021; 46:e44. [PMID: 34513650 PMCID: PMC8411003 DOI: 10.5395/rde.2021.46.e44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/24/2021] [Accepted: 04/19/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Mansi Bansal
- Department of Periodontology, Institute of Dental Studies and Technologies, Ghaziabad, India
| | - Manish Khatri
- Department of Periodontology, Institute of Dental Studies and Technologies, Ghaziabad, India
| | - Komal Puri
- Department of Periodontology, Institute of Dental Studies and Technologies, Ghaziabad, India
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Makeeva MK, Daurova FY, Byakova SF, Turkina AY. Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review. Clin Cosmet Investig Dent 2020; 12:447-464. [PMID: 33149696 PMCID: PMC7604462 DOI: 10.2147/ccide.s267933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/16/2020] [Indexed: 01/29/2023] Open
Abstract
The pulp and periodontium have obvious relationships that have been described in many studies. Pulp infections may affect periodontal tissues and vice versa. Teeth with endo-perio lesions have a worse prognosis than isolated endodontic or periodontal lesions. Elimination of endodontic and periodontal infections is essential for successful treatment, so co-operation between endodontists and periodontists is necessary. In this clinical case, a 44-year-old male presented with primary periodontal disease with secondary endodontic involvement in his lower right canine because of aggressive periodontitis. There was 10 mm of clinical attachment loss and 8 mm periodontal pocket mesial from the tooth and bone radiolucency periapical and lateral from the root. Periodontal therapy was followed by endodontic treatment. Periodontal therapy included root scaling and planing, treatment of the periodontal pocket with ozone gas, systemic antibiotics, oral hygiene instructions, and chlorhexidine rinsing. Endodontic therapy included root canal instrumentation with rotary endodontic files, irrigation, root canal treatment with ozone gas, and obturation with lateral compaction. Radiographs at a 6-month follow-up appointment showed complete healing of the periapical lesion and alveolar bone lateral to the root. Using an interdisciplinary approach to treat endo-perio lesions provides favorable clinical outcomes. Ozone therapy is beneficial for the successful treatment of endo-perio lesions with narrow periodontal pockets in patients with aggressive periodontitis and poor prognosis.
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Affiliation(s)
- Maria K Makeeva
- Conservative Dentistry Department, People's Friendship University of Russia (RUDN University), Moscow, Russia.,Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Fatima Yu Daurova
- Conservative Dentistry Department, People's Friendship University of Russia (RUDN University), Moscow, Russia
| | - Svetlana F Byakova
- Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anna Yu Turkina
- Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Goyal L, Gupta N, Gupta ND. Autologous platelet-rich derivatives along with alloplastic bone substitute in the management of complex perio-endo cases. J Indian Soc Periodontol 2020; 24:182-185. [PMID: 32189849 PMCID: PMC7069109 DOI: 10.4103/jisp.jisp_81_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/13/2019] [Accepted: 06/25/2019] [Indexed: 12/11/2022] Open
Abstract
Combined endodontic periodontal lesion is one of the most challenging dental conditions as making a definite diagnosis and henceforth treatment plan is a daunting task. The prognosis of complex lesion involving both endodontic and periodontic components is complex, but success rate can be improved with regenerative therapies. However, there is paucity of literature regarding its effectiveness in the clinical scenario as only few case reports have been documented in literature for the use of platelet-rich derivatives in regenerative osseous surgery requiring both endodontic and periodontal treatment. We are hereby presenting three cases requiring both endo and perio treatment. The first two cases involve mandibular first molar and maxillary first molar, respectively. The third case involves maxillary central incisor. In all the cases, first, endodontic treatment was initiated, then open flap curettage along with alloplastic bone substitutes was done. Platelet-rich fibrin and platelet-rich plasma were used along with. Three of the treated cases showed significant improvement radiographically and clinically. There was gain in clinical attachment, reduction in probing depth, and radiographic bone fill. Autologous platelet-rich derivative can be used in combination with alloplastic bone substitute for the management of endo-perio cases. Further long-term studies are needed to explore the clinical effectiveness of platelet-rich derivatives and predicting the probability of success of periodontal therapy.
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Affiliation(s)
- Lata Goyal
- Department of Dentistry, Division of Periodontics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Namita Gupta
- Department of Periodontics and Community Dentistry, Dr. Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Narinder Dev Gupta
- Department of Periodontics and Community Dentistry, Dr. Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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7
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Platelet-Rich Fibrin as a Bone Graft Material in Oral and Maxillofacial Bone Regeneration: Classification and Summary for Better Application. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3295756. [PMID: 31886202 PMCID: PMC6925910 DOI: 10.1155/2019/3295756] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/04/2019] [Indexed: 02/06/2023]
Abstract
Platelet-rich fibrin (PRF) is an autologous platelet concentrate that consists of cytokines, platelets, leukocytes, and circulating stem cells. It has been considered to be effective in bone regeneration and is mainly used for oral and maxillofacial bone. Although currently the use of PRF is thought to support alveolar ridge preservation, there is a lack of evidence regarding the application of PRF in osteogenesis. In this paper, we will provide examples of PRF application, and we will also summarize different measures to improve the properties of PRF for achieving better osteogenesis. The effect of PRF as a bone graft material on osteogenesis based on laboratory investigations, animal tests, and clinical evaluations is first reviewed here. In vitro, PRF was able to stimulate cell proliferation, differentiation, migration, mineralization, and osteogenesis-related gene expression. Preclinical and clinical trials suggested that PRF alone may have a limited effect. To enlighten researchers, modified PRF graft materials are further reviewed, including PRF combined with other bone graft materials, PRF combined with drugs, and a new-type PRF. Finally, we will summarize the common shortcomings in the application of PRF that probably lead to application failure. Future scientists should avoid or solve these problems to achieve better regeneration.
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Preliminary Results of Bone Regeneration in Oromaxillomandibular Surgery Using Synthetic Granular Graft. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8503427. [PMID: 30519588 PMCID: PMC6241370 DOI: 10.1155/2018/8503427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 09/17/2018] [Indexed: 11/28/2022]
Abstract
Traumatic, neoplastic, inflammatory, or infective dental removal promotes a gradual resorption process of bone which leads to a “nonuse” atrophy of the alveolar ridges. Many techniques allows restoring an appropriate bone thickness, but nowadays the attention is focused on the use of natural or synthetic grafts. Numerous studies have been conducted to develop and test new synthetic materials. In this article, the authors report their experience using a synthetic bone substitute in combination with Platelet Rich Fibrin (PRF). This technique was applied in different zones of the maxillomandibular district. The procedure showed a very satisfying bone regeneration without important complications.
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Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Periodontol 2018; 89 Suppl 1:S85-S102. [DOI: 10.1002/jper.16-0642] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 06/29/2017] [Accepted: 07/30/2017] [Indexed: 12/16/2022]
Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Belén Retamal-Valdes
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Magda Feres
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
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10
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Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Clin Periodontol 2018; 45 Suppl 20:S78-S94. [DOI: 10.1111/jcpe.12941] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 06/29/2017] [Accepted: 07/30/2017] [Indexed: 01/29/2023]
Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Belén Retamal-Valdes
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Magda Feres
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
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Hajizadeh N, Madani ZS, Zabihi E, Golpour M, Zahedpasha A, Mohammadnia M. Effect of MTA and CEM on Mineralization-Associated Gene Expression in Stem Cells Derived from Apical Papilla. IRANIAN ENDODONTIC JOURNAL 2018; 13:94-101. [PMID: 29692843 PMCID: PMC5800449 DOI: 10.22037/iej.v13i1.17860] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 10/17/2017] [Accepted: 10/28/2017] [Indexed: 01/18/2023]
Abstract
INTRODUCTION This study assessed the effect of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement on odontogenic differentiation and mineralization of stem cells. METHODS AND MATERIALS After confirmation of stemness and homogeneity of stem cells derived from apical papilla (SCAPs) using flow cytometry, the cells were exposed for 3 weeks to either osteogenic medium (OS) or CEM extract+OS (CEM+OS) or MTA extract in OS (MTA+OS) or DMEM based regular culture media (negative control). Relative expression of alkaline phosphatase (ALP), dentine sialophosphoprotein (DSPP), osteocalcin (OSC), and osterix (SP7) were measured at days 14 and 21 using RT-qPCR method. At the same time points Alizarin Red staining method was used to assess mineralization potential of SCAPS. Gene expression changes analysis were made automatically using REST® software and a P<0.05 was considered significant. RESULTS After 2 weeks of exposure, expression of all genes were between 3 and 52 times the expression of GADPH (all were upregulated except SP7 in the control, P<0.05). After 3 weeks, relative expressions of the genes: ALP, SP7, DSPP, and OSC were respectively 275.9, 528.3, 98.4, and 603.7 times the expression of GADPH in the control group (OS). These were respectively 17.405, 29.2, 11.8, and 6.5 in CEM+OS group, and 163.8, 119.7, 102.5, and 723.9 in MTA+OS group. All of these were confirmed as upregulated (P<0.05) except for ALP and OSC of DM+CEM group. After 2 weeks, alizarin red staining showed similar mineralized nodules in OS, MTA+OS, and CEM+OS. In third week, larger nodules were seen in MTA+OS and OS, but not in CEM+OS. CONCLUSION After 2 weeks, gene expressions were almost comparable in OS, CEM+OS, and MTA+OS. After 3 weeks, OS and MTA+OS upregulated genes much greater than in 2nd week. However, upregulation in CEM+OS might not increase in 3rd week compared to those in 2nd week.
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Affiliation(s)
- Niusha Hajizadeh
- Department of Endodontics, School of Dentistry, Babol University of Medical Sciences, Babol, Iran;
| | - Zahra Sadat Madani
- Dental Materials Research Center, School of Dentistry, Babol University of Medical Sciences, Babol, Iran;
| | - Ebrahim Zabihi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran;
| | - Moniyreh Golpour
- Molecular and Cell Biology Research Center, Student Research Committee, Medical School, Mazandaran University of Medical Sciences, Sari, Iran;
| | - Amir Zahedpasha
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Babol University of Medical Sciences, Babol, Iran;
| | - Mousa Mohammadnia
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran;
- Department of Immunology, School of Medicine Babol University of Medical Sciences, Babol, Iran
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Betancourt P, Elgueta R, Fuentes R. Treatment of endo-periodontal lesion using leukocyte-platelet-rich fibrin. A case report. COLOMBIA MEDICA (CALI, COLOMBIA) 2017; 48:204-207. [PMID: 29662262 PMCID: PMC5896727 DOI: 10.25100/cm.v43i4.2140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Case Description: The main objective of this paper was to report the clinical effectiveness of leukocyte- platelet- rich fibrin (L-PRF) in the treatment of a combined endo-periodontal lesion of an upper first premolar. Clinical Findings: The tooth had a profound abfraction on the vestibular aspect and presented no mobility but revealed a deep pocket measuring of 11 mm on the mesial vestibular aspect and 14 mm on the mesial palatine aspect. The three dimensional image analysis showed total bone loss in the mesial aspect and an extensively bone loss of the vestibular aspect of the vestibular root. Treatment and Outcome: Endodontic treatment was performed and periodontal access surgery (surgical periodontal therapy) was done with the application of autologous L-PRF. Three month and 6 months after surgery, the cone beam computed tomography (CBCT) exams showed no bone regeneration in any aspect of the tooth. However, periodontal examination showed a significative improvement in the deepness of surcus. The mesial vestibular aspect had a deep pocket of 3 mm and 5 mm on the mesial palatine aspect showing a reduction in deepness of 8 mm and 9 mm, respectively. Clinical Relevance: The actual treatment for teeth with bad prognosis is the extraction and replacement with implants. Even though implants are capable of restore function and aesthetic, the abuse of this approach have led to the loss of teeth that could be successfully treated with a less invasive technique. The prognosis of teeth with endoperiodontal lesion is poor but could be enhanced with regenerative therapies. Until now there are no clinical trials and just four case report about the treatment of these teeth with platelet rich fibrin.
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Affiliation(s)
- Pablo Betancourt
- Research Centre in Dental Sciences (CICO), Facultad de Odontología, Universidad de La Frontera, Temuco, Chile
| | - Ricardo Elgueta
- Research Centre in Dental Sciences (CICO), Facultad de Odontología, Universidad de La Frontera, Temuco, Chile.,Facultad de Odontologia , Universidad Mayor, Santiago de Chile, Chile
| | - Ramon Fuentes
- Research Centre in Dental Sciences (CICO), Facultad de Odontología, Universidad de La Frontera, Temuco, Chile
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Zhou T, Yang HW, Tian ZW, Wang Y, Tang XS, Hu JZ. Effect of Choukroun Platelet-Rich Fibrin Combined With Autologous Micro-Morselized Bone on the Repair of Mandibular Defects in Rabbits. J Oral Maxillofac Surg 2017. [PMID: 28651068 DOI: 10.1016/j.joms.2017.05.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE The aim of this study was to explore the effect of Choukroun platelet-rich fibrin (PRF) combined with autologous micro-morselized bone on the repair of mandibular defects in rabbits. MATERIALS AND METHODS Thirty-six healthy New Zealand rabbits were selected for the present study. After models of mandibular defects were established, rabbits were randomly divided into Choukroun PRF, autologous micro-morselized bone (autologous), Choukroun PRF combined with autologous bone (combined) and model groups. After the rabbits were sacrificed at 2, 8, and 12 weeks postoperatively, their bone formation was assessed by x-ray and scanning electron microscopy, and the histologic changes of the mandibular defect area were detected by hematoxylin and eosin staining. Cone-beam computed tomography was used to observe the size of the change of the mandibular defect area. Bone mineral density (BMD) was analyzed by dual-energy x-ray absorptiometry. RESULTS The bone defect in the combined group showed better repair, increased bone mineral content, and denser callus than the other groups, and the defect area was filled with mature trabecular bone. In the Choukroun PRF and autologous groups, the defect area was smaller and filled with osteoporotic trabecular bone. A clear mandibular defect area was still observed in the model group. Compared with the other groups, the combined group showed more bone regeneration, more fibrous tissue regeneration, and greater bone maturity at all time points. The combined group had the highest BMD, there was no relevant difference in BMD between the Choukroun PRF and autologous groups, and the model group had the lowest BMD. BMD in all 4 groups increased with time. CONCLUSION These findings indicate that Choukroun PRF combined with autologous micro-morselized bone can substantially improve the repair of mandibular defects in rabbits, and the effect is superior to Choukroun PRF or autologous micro-morselized bone alone.
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Affiliation(s)
- Tian Zhou
- Resident, Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Hua-Wei Yang
- Associate Chief Physician, Department of Stomatology, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Zhuo-Wei Tian
- Resident, Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yang Wang
- Attending Physician, Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xiao-Shan Tang
- Associate Chief Physician, Department of Stomatology, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Jing-Zhou Hu
- Associate Chief Physician, Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
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14
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Meschi N, Castro AB, Vandamme K, Quirynen M, Lambrechts P. The impact of autologous platelet concentrates on endodontic healing: a systematic review. Platelets 2016; 27:613-633. [PMID: 27658056 DOI: 10.1080/09537104.2016.1226497] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The current literature was reviewed to determine the impact of autologous platelet concentrates (APCs) on endodontic healing. All types of clinical study designs concerning any kind of endodontic treatment involving the application of APCs were included. Two independent reviewers searched three databases (PubMed, Embase, and Cochrane Library) for studies, complemented by hand search, until 16/1/2016. From the 423 identified records, 48 articles met the inclusion criteria. Selected randomized controlled clinical trials (RCTs) underwent Cochrane Collaboration's risk-of-bias assessment and data extraction. Only two RCTs showed low risk of bias. There was considerable heterogeneity between the RCTs with regard to the type of therapy, type of APCs, assessment method, and study quality, and therefore the data could not be analyzed quantitatively. The included case reports/series and non-randomized comparative studies underwent qualitative analysis with the revised Methodological Index for Non-Randomized Studies (MINORS) and data extraction. The two comparative non-randomized studies scored qualitatively high, though the MINORS-scores of the case series and reports were dispersed. APCs were involved in five endodontic treatment modalities, namely apexification, regenerative endodontic procedures, pulpotomy, apical surgery, and treatment of endo-perio/perio-endo lesions. APCs seem to accelerate postoperative bone healing, augment the patients' postoperative quality of life, aid further root development, and support maintenance/regaining of pulp vitality. No adverse events were reported. APCs in endodontic treatments seem to contribute to the healing of soft and hard tissues, though there is a lack of long-term high quality clinical trials and standardized treatment protocols.
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Affiliation(s)
- Nastaran Meschi
- a Department of Oral Health Sciences, Endodontology , KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Ana B Castro
- b Department of Oral Health Sciences , Periodontology, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Katleen Vandamme
- c Department of Oral Health Sciences , Restorative Dentistry, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Marc Quirynen
- b Department of Oral Health Sciences , Periodontology, KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
| | - Paul Lambrechts
- a Department of Oral Health Sciences, Endodontology , KU Leuven & Dentistry, University Hospitals Leuven , Leuven , Belgium
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15
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Rodella LF, Bonazza V. Platelet preparations in dentistry: How? Why? Where? When? World J Stomatol 2015; 4:39-55. [DOI: 10.5321/wjs.v4.i2.39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/08/2015] [Accepted: 04/30/2015] [Indexed: 02/06/2023] Open
Abstract
The aim of this article is to review the outcomes of platelet preparations in dentistry. A structured electronic search discovered 348 articles, which described the use of autologous platelet concentrates with a relevance to clinical dentistry. Among these articles, 220 articles investigated platelet rich plasma, 99 investigated platelet rich fibrin, 22 investigated plasma rich in growth factors and 7 investigated the use of concentrated growth factors. Several studies reported beneficial treament outcomes in terms of enhanced bone and soft tissue regeneration.
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Lee BN, Moon JW, Chang HS, Hwang IN, Oh WM, Hwang YC. A review of the regenerative endodontic treatment procedure. Restor Dent Endod 2015; 40:179-87. [PMID: 26295020 PMCID: PMC4534721 DOI: 10.5395/rde.2015.40.3.179] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 01/29/2015] [Indexed: 01/09/2023] Open
Abstract
Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.
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Affiliation(s)
- Bin-Na Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Jong-Wook Moon
- School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Hoon-Sang Chang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - In-Nam Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Won-Mann Oh
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Yun-Chan Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
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E. D, Kumar A, Tewari RK, Mishra SK, Iftekhar H. Management of large preiapical lesion with the combination of second generation platelet extract and hydroxyapatite bone graft: a report of three cases. J Clin Diagn Res 2015; 9:ZD24-7. [PMID: 25738094 PMCID: PMC4347185 DOI: 10.7860/jcdr/2015/10885.5482] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 11/05/2014] [Indexed: 12/30/2022]
Abstract
The pulp tissue necrosis and extensive periodontal diseases leads to the development of the inflammatory periapical lesion which causes a local response of bone around the apex of the tooth. Depends upon the nature of wound and available biological growth factors the outcome will be either regeneration or repair. Being a rich source of growth factors, platelet rich fibrin (PRF) posses many advantages in bone regeneration. The purpose of this case report is to present an attempt to evaluate the healing potential of the combination of PRF and Hydroxyapatite bone graft as opposed to using these materials alone. A periapical endodontic surgery was performed on three patients with a large periapical inflammatory lesion and a large bony defect. The defect was then filled with a combination of PRF and Hydroxyapatite bone graft crystals. Clinical examination exhibited uneventful wound healing. The HA crystals have been replaced by new bone radiographically at the end of two years in Case 1 and Case 2, Case 3 were followed upto one year. On the basis of our cases outcome, we conclude the use of PRF in combination with HA crystals might have accelerate the bone regeneration.
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Affiliation(s)
- Deenadayalan E.
- Resident, Department of Conservative Dentistry and Endodontics, Aligarh Muslim University, Aligarh, India
| | - Ashok Kumar
- Professor, Department of Conservative Dentistry and Endodontics, Aligarh Muslim University, Aligarh, India
| | - Rajendra Kumar Tewari
- Professor and Principal, Department of Conservative Dentistry and Endodontics, Aligarh Muslim University, Aligarh, India
| | - Surendra Kumar Mishra
- Professor and Chairman, Department of Conservative Dentistry and Endodontics, Aligarh Muslim University, Aligarh, India
| | - Huma Iftekhar
- Assistant Professor, Department of Conservative Dentistry and Endodontics, Aligarh Muslim University, Aligarh, India
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