A comparative evaluation of Advanced Platelet-Rich Fibrin (A-PRF) and Platelet-Rich Fibrin (PRF) as a Scaffold in Regenerative Endodontic Treatment of Traumatized Immature Non-vital permanent anterior teeth: A Prospective clinical study

Veena Jayadevan; Paras-Mull Gehlot; Vinutha Manjunath; Subbarao V Madhunapantula; Jyothi-Swandenahalli Lakshmikanth

doi:10.4317/jced.57902

A comparative evaluation of Advanced Platelet-Rich Fibrin (A-PRF) and Platelet-Rich Fibrin (PRF) as a Scaffold in Regenerative Endodontic Treatment of Traumatized Immature Non-vital permanent anterior teeth: A Prospective clinical study

J Clin Exp Dent. 2021 May 1;13(5):e463-e472. doi: 10.4317/jced.57902. eCollection 2021 May.

Authors

Veena Jayadevan¹, Paras-Mull Gehlot², Vinutha Manjunath², Subbarao V Madhunapantula³, Jyothi-Swandenahalli Lakshmikanth⁴

Affiliations

¹ BDS. Department of Conservative Dentistry and Endodontics. JSS Dental College and Hospital. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India.
² MDS. Department of Conservative Dentistry and Endodontics. JSS Dental College and Hospital. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India.
³ BSc, B.Ed, M.Sc, Ph.D. Department of Biochemistry. JSS Medical College and Hospital. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India.
⁴ M Pharm. Department of Pharmaceutics. JSS College of Pharmacy. JSS Academy of Higher Education and Research. Sri Shivarathreeshwara Nagar. Mysuru- 570015, Karnataka, India.

Abstract

Background: Regenerative endodontic treatment (RET) is a promising treatment alternative for traumatized immature non-vital teeth. Advanced platelet-rich fibrin (A-PRF) contains significantly more growth factors than Platelet-rich fibrin (PRF) and has not been evaluated as a scaffold in RET. The aim of the present study was to evaluate and compare A-PRF and PRF as scaffolds in the RET concerning periapical healing, and root development of traumatized immature non-vital teeth.

Material and methods: In the present study, RET was performed on 30 traumatized immature non-vital maxillary incisors in 28 patients aged between 8-27 years. Minimal mechanical debridement and irrigation with 1.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid was performed. Canals were disinfected using modified triple antibiotic paste consisting of ciprofloxacin, metronidazole and cefaclor. Based on the type of scaffold, teeth were randomly assigned into A-PRF (n=15) and PRF groups (n=15). Periapical healing, apical response and quantitative root dimensions (length and thickness) were analyzed radiographically after 12 months follow-up.

Results: Nineteen patients with 21 teeth (A-PRF n=11, PRF n=10) completed the follow-up and 9 patients were excluded. Clinically, patients in both the groups were asymptomatic. The survival rates for A-PRF and PRF were 78.5% and 77.5%, respectively. No statistically significant differences were detected between A-PRF and PRF regarding periapical healing and type of apical response (p& 0.05). The difference in the pre-operative and follow-up root thickness and root length in both A-PRF and PRF groups were statistically significant (p< 0.05).

Conclusions: Based on short-term results of 13 months, both A-PRF and PRF can be used as scaffold in regenerative endodontic treatment of traumatized immature non-vital teeth. A-PRF could be recommended in such cases since it yielded more root dentin thickness which is crucial for reinforcing immature teeth. Key words:Regenerative endodontic treatment, dental trauma, Non-vital teeth, immature teeth, platelet-rich fibrin, advanced platelet-rich fibrin.