Necrotic Pulp Clinical Trial
Official title:
Evaluation of the Efficacy of Injectable Platelet-Rich Fibrin Versus Platelet-Rich Plasma in the Regeneration of Necrotic Immature Maxillary Anterior Teeth. (A Randomized Clinical Trial)
Injectable platelet-rich fibrin (I-PRF) is a flowable blood concentrate that is entirely
natural and allows ease of access and flow within the root canal. It was first developed in
2014 by modifying the centrifugation parameters. I-PRF has great potential in the field of
endodontics. At present, it is still in its infancy and needs to be explored with regard to
its regenerative efficacy.
To the best of our knowledge, this study is the first to clinically and comparatively
investigate Platelet-rich plasma (PRP) and I-PRF.
An ideal treatment option for an immature necrotic tooth is the regeneration of pulp-like
tissue that is capable of boosting the continuation of normal root development. The use of
platelet concentrates for that purpose is a clinically relevant, minimally invasive approach
which has a promising potential of reducing the healing period. Among which, the most
commonly employed is the Platelet-Rich Plasma that is not entirely natural. It involves the
use of non-autologous anticoagulants such as bovine thrombin to maintain the fluid
consistency which prevents clot formation and thus impairs wound healing, affects the
coagulation process and can also trigger an immune reaction, thereby, suppressing
regeneration.
PRP offers a short-term release of most of the growth factors unlike the Platelet-Rich Fibrin
which allows for a more sustained release. PRF does not require any biochemical handling of
blood and is easy to procure but due to the gel-like consistency, its adaptability within the
root canal requires excessive removal of root dentin.
In addition, the application of recombinant growth factors within the root canal is
associated with high cost which hinders its applicability in the common clinical practice.
Therefore, a new regenerative technique is required that combines the advantages of both PRP
and PRF while overcoming their drawbacks.
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