Treatment of experimental furcation perforations with mineral trioxide aggregate, platelet rich plasma or platelet rich fibrin in dogs' teeth.

This work evaluates the effect of mineral trioxide aggregate (MTA), platelet rich plasma (PRP) or platelet rich fibrin (PRF) on healing of non-contaminated and contaminated furcation perforations. A total of 192 teeth of 12 dogs was divided into three equal groups according to evaluation period. Each group was further subdivided into MTA, PRP, PRF, negative and positive control subgroups. Each experimental subgroup was further subdivided according to perforation status into non-contaminated and contaminated subdivisions. Root canal therapy was carried out and furcation perforation was made in all teeth except in negative control subgroup. The furcation perforation was repaired immediately in subdivision (1) and after 4 weeks in subdivision (2). The change in vertical bone loss was measured by radiography. Inflammatory cell count, cemental deposition, new bone formation, bone resorption and epithelial proliferation were assessed. Both PRP and PRF demonstrated statistically significant reduction in vertical bone loss and inflammatory cell count than MTA. No significant difference was found between MTA, PRP and PRF in cemental deposition, new bone formation, bone resorption and epithelial proliferation. The non-contaminated teeth demonstrated better treatment outcomes than the contaminated teeth. In conclusion, PRP and PRF are successful treatment options for repairing of furcation perforation in both non-contaminated and contaminated teeth in dogs with superior outcomes in non contaminated teeth.

Regenerative potential of immature permanent teeth with necrotic pulps after different regenerative protocols.

INTRODUCTION: Regenerative endodontics is a promising alternative treatment for immature teeth with necrotic pulps. The present study was performed to assess the regenerative potential of young permanent immature teeth with necrotic pulp after the following treatment protocols: (1) a mineral trioxide aggregate (MTA) apical plug, (2) the regenerative endodontic protocol (blood clot scaffold), and (3) the regenerative endodontic protocol with a blood clot and an injectable scaffold impregnated with basic fibroblast growth factor. METHODS: Immature necrotic permanent maxillary central incisors (n = 36) of patients 9-13 years old were divided into 3 groups according to the treatment protocol: the MTA group (MTA apical plug), the REG group (regenerative endodontic protocol [blood clot]), and the FGF group (regenerative endodontic protocol [blood clot + injectable scaffold]). Follow-up was done up to 18 months. Standardized radiographs were digitally evaluated for an increase in root length and thickness, a decrease in the apical diameter, and a change in periapical bone density. RESULTS: After a follow-up period of 18 months, most of the cases showed radiographic evidence of periapical healing. Groups 2 and 3 showed a progressive increase in root length and width and a decrease in apical diameter. CONCLUSIONS: The regenerative endodontic procedure allowed the continued development of roots in teeth with necrotic pulps. The use of artificial hydrogel scaffold and basic fibroblast growth factor was not essential for repair.