Regenerative endodontic therapy using platelet-rich fibrin in children

P. Singhal, Bindu Kadian, Pawan Midha, R. Namdev
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Abstract

Regeneration of pulp–dentin complex in an infected necrotic tooth with an open apex is possible if the canal is effectively disinfected. The purpose of this case report is to add regenerative endodontic cases to the existing literature about the use of plateletrich fibrin (PRF). Three clinically and radiographically diagnosed necrotic immature permanent teeth were treated using PRF as a scaffold for revascularization. The therapeutic protocol involved accessing the pulp chamber, irrigating copiously with sodium hypochlorite, applying a triple antibiotic paste as intracanal dressing, and then provisionally sealing it. After 3–4 weeks, the canal was cleaned and PRF was introduced in the canal that would serve as a scaffold for pulp revascularization. Mineral trioxide aggregate was used to seal the chamber and finally restored with composite. All the cases treated with PRF as a scaffold showed magnificant healing and apical end closure along with thickening of dentinal walls. On the basis of the results obtained in our case reports, we conclude that the revitalization of necrotic infected immature tooth is possible under conditions of total canal disinfection, and PRF is nearly an ideal biomaterial for pulp–dentin complex regeneration.
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富血小板纤维蛋白用于儿童再生牙髓治疗
如果根管有效消毒,牙髓-牙本质复合体的再生是可能的。本病例报告的目的是增加再生根管病例到现有文献中关于使用富血小板纤维蛋白(PRF)。三颗临床和影像学诊断为坏死的未成熟恒牙使用PRF作为支架进行血管重建术。治疗方案包括进入髓腔,用次氯酸钠大量冲洗,应用三重抗生素膏体作为管内敷料,然后暂时密封。3-4周后,清洁根管,将PRF引入根管内,作为髓质血运重建的支架。采用矿物三氧化骨料对腔室进行密封,最后用复合材料进行修复。用PRF作为支架治疗的所有病例均表现出良好的愈合和根尖端闭合,牙本质壁增厚。根据我们的病例报告结果,我们认为在全管消毒的条件下,坏死感染的未成熟牙齿是可能恢复活力的,PRF是一种理想的髓质-牙本质复合体再生的生物材料。
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