Pulp revascularization using platelet rich plasma versus conventional blood clot technique in necrotic immature permanent teeth topromote periapical healing and continued root development : A randomized controlled trial / Ahmed Shawky Elsheshtawy ; Supervised Khaled M. Ezzat , Alaa Abdelsalam Elbaz , Osama I. Elshahawy

Thesis (Ph.D.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Endodontics

Aim: The aim of this randomized clinical trial was to evaluate the clinical and radiographic outcomes of revascularization using platelet rich plasma versus conventional blood clot technique for treatment of immature permanent teeth with necrotic pulp with or without apical periodontitis. This study also aimed at giving a time-to event insight about the radiographic changes following such proceduresSubjects and methods:Subjects were enrolled into the trial according to preset eligibility criteria and were randomly allocated into two groups, the PRP group in which the intervention was REPs using PRP as a scaffold and BLC group in which the intervention was REPs using blood clot as a scaffold.Baseline data were collected by a standardized digital periapical radiographs and limited FOV CBCT scans. The revascularization procedures involved a disinfection visit using full concentration NaOCl and placement of TAP for 21 days.After resolution of signs and symptoms of active infection, the second visit involves a final rinse protocol using 2.5% NaOCl and 17% EDTA followed by execution of the regenerative procedures indicated for each group.Patients in both groups were followed up for 1 year,and examined at 3 months intervals using standardized digital periapical radiographs. At the 12 month time point, a final limited FOV CBCT scan is performed and compared to the baseline data. Evaluation of radiographic root changes after REPs in both groups was performed using Image J software and TurboReg plug-in for mathematical correction and alignment of baseline and follow-up radiographs. The software was used to quantify the radiographic changes in terms of;increase in root length, increase in dentin wall thickness at the apical third, decrease in the diameter of the apical foramen and increase in total RRA. Evaluation of periapical healing was performed by comparing post-operative CBCT scans to baseline scans to determine the percentage of decrease in lesion size-if present- after REPs

Issued also as CD