Management of internal inflammatory root resorption using injectable platelet-rich fibrin revascularization technique: a clinical study with cone-beam computed tomography evaluation

OBJECTIVES

The current study evaluated clinically and radiographically the management of internal inflammatory root resorption (IIRR) in permanent anterior teeth with or without periapical lesions using injectable platelet-rich fibrin (i-PRF) regenerative approach.

METHODS

Ten systemically healthy patients, with thirteen anterior mature teeth diagnosed with IIRR were selected for the study. At the first visit, the tooth was anesthetized, access cavity opened, root canals were mechanically prepared then medicated with calcium hydroxide and temporarily sealed. After 2-4 weeks, regenerative endodontic procedures were performed by preparing and applying i-PRF inside the canal, then a freshly prepared PRF membrane was placed over it. White mineral trioxide aggregate was placed over the PRF matrix, and the tooth was restored with a glass ionomer cement base and resin composite restoration. The patients were recalled for clinical and radiographic evaluation and follow-up every 3 months for 12 months. Cone-beam computed tomography (CBCT) imaging was performed preoperatively and after 12 months.

RESULTS

Clinical evaluation results showed resolution of signs and symptoms through the follow-up period in all of the cases. Both CBCT imaging readings of IIRR lesions and periapical lesions revealed a volumetric significant difference (p = 0.00) between the preoperative and the 12-month follow-up period.

CONCLUSIONS

Usage of i-PRF could arrest and allow for healing of IIRR in permanent mature teeth and allow for periapical healing with successful clinical results.

CLINICAL RELEVANCE

i-PRF revascularization technique proved to be a successful REP in the treatment of the IIRR, reducing the number of appointments and increasing patient compliance.

A Cre-expressing cell line and an E1/E2a double-deleted virus for preparation of helper-dependent adenovirus vector

Adenoviral vectors are attractive for the delivery of transgenes into mammalian cells because of their efficient transduction, high titer, and stability. The major concerns with using E1-deleted adenoviral vectors in gene therapy are the pathogenic potential of the virus backbone and the leaky viral protein synthesis that leads to host immune responses and a short duration of transgene expression. Helper-dependent (HD) adenoviral vectors that are devoid of all viral protein-coding sequences have significantly increased the safety and reduced the immunogenicity of these vectors. Currently available HD vectors depend on an E1-deleted adenovirus as a helper to provide viral proteins in trans. As a consequence, contamination with helper virus cannot be avoided in the HD vector preparation though it can be decreased to 0.01% using a Cre/loxP mechanism. Since the presence of E1-deleted helper virus may have substantial unwanted effects, we have developed a new Cre-expressing cell line based on an E1- and E2a-complementing cell. This new cell line can efficiently cleave the packaging region in the helper virus genome. We have also developed an E1 and E2a double-deleted helper virus. By using the CreE cell with the helper virus deleted in both the E1 and the E2a genes it may be possible to further improve the safety of the vectors.