ABSTRACT
BACKGROUND: This study aimed to evaluate the area of dentin growth in rabbit incisors after pulp capping with plasma rich in growth factors (PRGF) compared with mineral trioxide aggregate (MTA) by fluorescence. METHODS: twenty-seven upper and lower incisors of rabbits were divided into 4 groups: poor PRGF (F1) (n = 9 teeth), rich PRGF (F2) (n = 8 teeth), ProRoot MTA (positive control, n = 5 teeth), and untreated (NC) (negative control, n = 5). Fluorochrome markers were injected 24 h before surgery and the day before euthanasia, 28 days after the vital pulp therapy (VPT). Two transverse cuts were performed to every tooth: the first cut (A), 1 mm incisal to the gingival margin, and the second cut (B), 5 mm apical to the first cut. The sections were assessed with histomorphometric evaluation by fluorescence microscopy, comparing the dentin area between fluorescence marks and the total mineralized area. RESULTS: The higher percentage of dentin growth was observed in the F2 group (B = 63.25%, A = 36.52%), followed by F1 (B = 57.63%, A = 30,12%) and MTA (B = 38.64%, A = 15.74%). The group with lowest percentage of dentin growth was the NC group (B = 29.22%, A = 7.82%). Significant difference (p < 0.05) was found between F2 group and MTA, also statistically significant difference has been observed comparing dentin growth areas of NC group with F1 and F2 groups. CONCLUSIONS: The application of PRGF rich and poor fraction as a pulp capping material stimulated dentin formation more intensively than MTA and NC.
ABSTRACT
INTRODUCTION: Regenerative endodontic procedures (REP) are a promising alternative for necrotic immature teeth in adolescents and children, but very little evidence is available on this alternative in long-lasting necrotic teeth with open apices in adults. REPs are designed to replace damaged structures of the pulp-dentin complex, but no regeneration has been obtained in any of the cases described in necrotic immature permanent teeth with apical periodontitis with histologic results. The results are limited to periapical tissue repair with increasing root length, thickening of the root walls, and apical closure in young patients. In this series of cases, we report on the outcomes of the adjuvant use of autologous platelet-rich plasma (PRP) in endodontic therapy in adults by monitoring periapical tissue healing with periodic periapical radiographs and cone-beam computed tomographic scanning. METHODS: Three teeth with apical periodontitis and open apices in 3 different patients from 21 to 35 years-old were evaluated. An REP was performed with the adjuvant use of PRP. RESULTS: At controls, complete disappearance of the radiolucent lesions and the presence of calcified structures forming bridges occupying the pulp lumen were observed but not an ostensible thickening of root walls with a regeneration of pulp-dentin complex. CONCLUSIONS: The repair of periapical tissues with REPs of open apex teeth with apical periodontitis and in nonsurgical endodontic retreatment appears to be feasible in adults, but no regeneration was obtained in any of the present cases. The use of PRP may be a good choice as an autologous matrix because of its stability and induction; it contains growth factors and bioactive molecules like transforming growth factor beta, bone morphogenic proteins, insulinlike growth factors, and angiogenetic growth factors, which stimulate collagen production, angiogenesis, and cell differentiation. Anti-inflammatory and antibacterial properties have also been reported for this preparation, which are involved in all processes of repair.
