Retreatment of endodontically failed tooth with wide-open apex using platelet rich fibrin membrane as matrix and an apical plug of Biodentine™

A BSTRACT Background: The chances of extrusion of mineral trioxide aggregate (MTA) are quite high if apical barrier is not present in immature pulpless permanent teeth. Platelet-rich fibrin (PRF) enriched with platelets and growth factors serves to accelerate the wound healing of periapical lesion in immature pulpless permanent teeth and also serves as internal matrix to condense MTA. Aim: The aim of the present study was to comprehensively review the clinical success of MTA+PRF in healing of periapical lesions in immature pulpless permanent teeth. Materials and Methods: An electronic search for systematic review was conducted in Pubmed/Medline ( www.ncbi.nlm.nih.gov ), Cochrane ( www.cochrane.org ), Scopus ( www.scopus.com ) databases upto 15th January 2020 related to the healing of periapical lesions in permanent teeth with immature apices when combination of MTA+PRF was used. A sample of 10 relevant studies and case reports were identified in our search out of 65. The sampling method was simple random technique. The studies and case reports with Randomised Controlled Trials(RCTs), Invitro studies, Case reports and animal studies in healing of periapical lesion were included in our comprehensive systematic review. Results: The search showed that the combination of MTA+PRF showed faster and definite periapical lesion healing in immature permanent teeth. The follow-up period was also recorded in all the relevant studies and case reports. Conclusion: Acclerated bone filling was seen in healing of periapical leions when MTA+PRF was used.

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“…Pawar et al [ 17 ] reported healing of periapical lesion in a failed attempt of revascularization, when MTA and PRF were used together.…”

Section: Discussionmentioning

confidence: 99%

Clinical success of platelet-rich fibrin and mineral trioxide aggregate (MTA) or MTA-like agents in healing of periapical lesion in nonsurgically treated pulpless immature permanent teeth: A systematic review

Joshi

Palekar

Pendyala

et al. 2020

J Int Soc Prevent Communit Dent

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“…Thermo-plasticized gutta percha technique is not recommended for the tooth with periapical lesion and open apex, without apical barrier matrix because of wide apical foramen and uncontrolled length of working distance [ 1 , 10 , 16 , 17 , 28 ]. Once the apical plug of MTA has been established, any obturation techniques could have been performed to fill the remaining space of the root canal.…”

Section: Discussionmentioning

confidence: 99%

Platelet-rich fibrin as an apical barrier for MTA placement in the treatment of teeth with open apices: a pilot study

Pham,

Pham

et al. 2024

J Transl Med

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Objective The aim of the present pilot study was to assess the effectiveness of the platelet-rich fibrin (PRF) apical barrier for the placement of MTA for the treatment of teeth with periapical lesions and open apices. Methods A total of thirty teeth on twenty-eight patients with open apices and periapical periodontitis were enrolled and divided into two groups in the present pilot study. In the PRF group (fourteen teeth in thirteen patients), nonsurgical endodontic treatment was performed using PRF as an apical matrix, after which the apical plug of the MTA was created. For the non-PRF group (fourteen teeth in fourteen patients), nonsurgical endodontic therapy was performed using only the MTA for an apical plug with no further periapical intervention. Clinical findings and periapical digital radiographs were used for evaluating the healing progress after periodic follow-ups of 1, 3, 6, and 9 months. The horizontal dimension of the periapical lesion was gauged, and the changes in the dimensions were recorded each time. The Friedman test, Dunn-Bonferroni post hoc correction, and Mann-Whitney U test were used for statistical analysis, with P < 0.05 serving as the threshold for determining statistical significance. Results All patients in both groups in the present pilot study had no clinical symptoms after 1 month, with a significant reduction in the periapical lesion after periodic appointments. The lesion width of the PRF group was significantly smaller than that of the non-PRF group in the sixth and ninth month after treatment. Conclusions PRF is a promising apical barrier matrix when combined with MTA for the treatment of teeth with open apices and periapical periodontitis. Small number of study subjects and the short time of follow-up period limit the generalizability of these results. Trial registration TCTR, TCTR20221109006. Registered 09 November 2022 - Retrospectively registered, https://www.thaiclinicaltrials.org/show/TCTR20221109006.

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“…The literature shows that no instrument or technique can completely remove root canal filling materials from the root canal system during non-surgical root canal retreatment [1], [3], [13], [14], [15], [16], [17] which can ultimately result in treatment failures because of the inability to eliminate microorganism from the root canal system [4]. Therefore, new instruments and supplementary protocols for remaining filling material removal have been proposed [5], [18], [19], [20].…”

Section: Discussionmentioning

confidence: 99%

“…The primary reason for an endodontic failure is the persistence or regrowth of bacteria within the root canal system which requires retreatment [1], the success of retreatment depends on the efficient removal of the entire root filling material from the root canal system [2].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Two Novel Retreatment Systems in the Removal of Root Canal Obturating Materials (An In vitro Study)

Sameh

Omaia

2022

Open Access Maced J Med Sci

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BACKGROUND: The complete removal of root filling material is one of the main goals of non-surgical endodontic retreatment. Thus, the development of new techniques and instruments aiming to promote this task presents clinical significance. AIM: The purpose of the study was to assess the amount of residual root canal filling materials (gutta-percha/sealer) after using two different endodontic retreatment systems and ultrasonic tip. METHODS: Forty-five mandibular premolar teeth were mechanically instrumented and obturated. Retreatment was performed using two different Endostar RE (Group 2), Rogin retreatment system (Group 3), and ultrasonic tip (Group 1). Roots were separated buccolingually into two halves. A digital camera connected to the stereomicroscope captured images to each half. Image-J software was used to evaluate and measure the areas with remaining filling material in each third (cervical, middle, and apical). RESULTS: Data analysis revealed significant differences between the groups in the coronal, middle, and apical thirds (p < 0.05). The ultrasonic retreatment tips (G1) were significantly more efficient in removing the gutta-percha and sealers compared to the Rogin (G3) and Endostar (G2) retreatment endodontic kits. CONCLUSIONS: All the file systems left some filling material in the canals. Ultrasonic retreatment tip had maximum efficacy for the removal of filling materials in comparison with the retreatment file systems under investigation.

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Retreatment of endodontically failed tooth with wide-open apex using platelet rich fibrin membrane as matrix and an apical plug of Biodentine™

Cited by 10 publications

References 25 publications

Clinical success of platelet-rich fibrin and mineral trioxide aggregate (MTA) or MTA-like agents in healing of periapical lesion in nonsurgically treated pulpless immature permanent teeth: A systematic review

Clinical success of platelet-rich fibrin and mineral trioxide aggregate (MTA) or MTA-like agents in healing of periapical lesion in nonsurgically treated pulpless immature permanent teeth: A systematic review

Platelet-rich fibrin as an apical barrier for MTA placement in the treatment of teeth with open apices: a pilot study

The Efficacy of Two Novel Retreatment Systems in the Removal of Root Canal Obturating Materials (An In vitro Study)

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