Efficacy of platelet-rich plasma as a scaffold in regenerative endodontic treatment

J Endod. 2015 Jan;41(1):36-44. doi: 10.1016/j.joen.2014.10.004. Epub 2014 Nov 12.

Abstract

Introduction: Current research is concerned with discovering better scaffolds for use in regenerative endodontic treatment. This study aimed to clinically and radiographically evaluate the efficacy of platelet-rich plasma (PRP) used as a scaffold in regenerative endodontic treatment and compare it with that of a conventional blood clot (BC) scaffold.

Methods: A total of 20 necrotic, single-rooted immature teeth were randomly distributed into 2 groups. After disinfecting the root canal space with triple antibiotic paste (1:1:1 ciprofloxacin, metronidazole, and cefaclor), a tissue scaffold was created by using either PRP or BC and covered with white mineral trioxide aggregate. Clinical and radiographic follow-up examinations were performed once every 3 months during an 18-month period. Differences in root area were calculated from preoperative and postoperative radiographs. Fisher exact and Mann-Whitney U tests were used to evaluate differences between groups, with P value <.05 considered to be statistically significant.

Results: All 20 teeth were clinically asymptomatic during 18-month follow-up period; however, 1 tooth in the BC group exhibited periapical pathosis and was judged radiographically unsuccessful. Complete apical closure was observed in a mean of 8.1 months in the PRP group compared with 9 months in the BC group. The PRP group exhibited 9.86% increase in root area, compared with 12.6% increase in the BC group. The difference in success rates between the groups was not statistically significant (P > .05).

Conclusions: PRP successfully created a scaffold for regenerative endodontic treatment; however, treatment outcomes did not differ significantly between PRP and conventional BC scaffold.

Keywords: Blood clot; immature teeth; platelet-rich plasma; regenerative endodontic treatment.

MeSH terms

  • Adolescent
  • Aluminum Compounds
  • Anti-Bacterial Agents / administration & dosage
  • Calcium Compounds
  • Child
  • Dental Pulp
  • Dental Pulp Necrosis / pathology
  • Dental Pulp Necrosis / therapy*
  • Drug Combinations
  • Female
  • Humans
  • Male
  • Oxides
  • Platelet-Rich Plasma*
  • Random Allocation
  • Regeneration / drug effects
  • Regeneration / physiology*
  • Root Canal Filling Materials / therapeutic use
  • Root Canal Preparation
  • Root Canal Therapy / methods*
  • Silicates
  • Thrombosis
  • Tissue Scaffolds*
  • Tooth Apex / drug effects
  • Tooth Apex / pathology
  • Tooth Root / pathology
  • Treatment Outcome

Substances

  • Aluminum Compounds
  • Anti-Bacterial Agents
  • Calcium Compounds
  • Drug Combinations
  • Oxides
  • Root Canal Filling Materials
  • Silicates
  • mineral trioxide aggregate