PLATELET RICH FIBRIN SCAFFOLD COMBINED WITH INDUCED BLOOD CLOT IN PULP REVASCULARIZATION OF NECROTIC IMMATURE PERMANENT TEETH WITH CHRONIC PERIAPICAL LESIONS: A CASE SERIES

Abstract

ABSTRACT Background: Traumatized non-vital permanent teeth with incomplete root formation and divergent apices present particular challenges to clinicians during management with traditional approaches. Objectives: This report described the outcomes of pulp revascularization of three traumatized immature necrotic permanent teeth using platelet-rich fibrin scaffold combined with induced blood clot. Materials and Methods: Three patients (two boys aged 8 and 11 years and one girl aged 13 years) were presented with immature maxillary incisors with necrotic pulps. Access cavities were prepared and the root canals were gently irrigated with 1.5% sodium hypochlorite (20 mL/ 5 min). Calcium hydroxide paste was applied three mm short of the root apex and the canals were temporized with intermediate restorative material. At the following appointment after two weeks, the teeth were treated by revascularization protocol using Platelet rich fibrin scaffold combined with induced blood clot and the three cases were clinically and radiographically followed up to eighteen months. Results: The patients were clinically asymptomatic at all follow-up periods. Cone Beam Computed Tomography (CBCT) images revealed evidence of root maturation and healing of the periapical lesions. Calcific intra-canal deposits were noted at the middle and apical thirds of the root canals. Conclusions: Pulp revascularization procedure using Platelet rich fibrin scaffold showed evidence of root elongation, increased dentin thickness and resolution of the periapical lesions.