Radiographic and immuno-histochemical evaluation of root perforation repair using MTA with or without platelet-rich fibrin or concentrated growth factors as an internal matrix in dog's teeth: in vivo animal study.

Abstract

To comparatively evaluate the in vivo outcome of MTA repair for contaminated and non-contaminated furcation perforations (FP) with or without PRF and CGF as a matrix in dogs' teeth. Ninety dog teeth were divided into five groups based on the iatrogenic FP repair approach after doing root canal treatment: negative control (without FP), positive control (FP without repair), MTA, MTA + PRF and MTA + CGF groups, where FP were repaired promptly in subdivision 1 (n = 10; non-contaminated) and after 4weeks of oral contamination in subdivision 2 (n = 10;contaminated). After 3months, the perforation site was assessed radiographically (vertical bone density), histologically (inflammatory cell count, epithelial proliferation, cementum and bone deposition) and immunohistochemically (OPN and TRAP antibodies localisation). Data collected were statistically analysed using SPSS software at a 0.05 significance level. The MTA + PRF and MTA + CGF groups demonstrated significantly more bone formation, OPN immunolocalisation and fewer inflammatory cell counts than MTA group. MTA, MTA + PRF and MTA + CGF groups showed significantly favourable radiographic, histological and immunohistochemical healing features than the positive control, especially in non-contaminated subdivisions, that significantly showed better features than the contaminated subdivisions (P < 0.001). The use CGF and PRF as a matrix beneath MTA in FP repair in dog's teeth is promising as it could increase hard and soft tissue regeneration in non-contaminated and contaminated perforations. The repair of FP is challenging especially when associated with contaminated inter-radicular bone loss. Radiographic, histological and immunohistochemical comprehensive evaluation of the root and surrounding attachment apparatus response to different perforation repair protocols could give a predictable clinical outcome.