Comparison of the Effect of PRP, PRF and Induced Bleeding in the Revascularization of Teeth with Necrotic Pulp and Open Apex: A Triple Blind Randomized Clinical Trial
Comparison of the Effect of PRP, PRF and Induced Bleeding in the Revascularization of Teeth with Necrotic Pulp and Open Apex: A Triple Blind Randomized Clinical Trial
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DOI：
10.7860/jcdr/2017/22352.10056
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发表时间：
2017-06-01
影响因子：
0.2
通讯作者：
Renganathan, Senthil Kumar
中科院分区：
文献类型：
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作者：
Shivashankar, Vasundara Yayathi;Johns, Dexton Antony;Renganathan, Senthil Kumar
前言：牙髓坏死根尖开放牙的治疗对临床医生来说是一个特殊的挑战。氢氧化钙根尖诱导成形术和MTA屏障技术不能诱导牙根继续成熟，这使得牙齿容易发生牙根折裂。因此，一个理想的结果，这样的牙齿应该是再生的牙髓样组织进入根管能够继续正常的rootmatching.Aim：本研究的目的是比较血小板丰富的Fiorescence（PRF），诱导出血技术和血小板丰富的血浆（PRP）在坏死的牙髓和开放的根尖的牙齿血运重建的效果。本研究的主要目的是：（a）通过放射学方法评价根管发育的持续性、牙本质壁厚度的增加和根管间隙的变窄、根尖封闭和根尖周病变的解决;以及（B）临床评价对牙髓敏感性测试的反应以及对叩诊和触诊测试的反应。将60例6 ~ 28岁的年轻恒牙根管消毒后随机分为3组。A组20例采用PRF作为支架材料，B组20例采用传统的诱导出血技术，C组20例采用PRP作为生物材料。使用根尖周指数（派）（用于根尖周愈合）、Chen和Chen指数（用于根尖反应）、Schei尺（用于牙根延长和牙根增厚）和其他临床参数测量主要结局变量。在12个月结束时，使用卡方检验来解释三组之间的变量牙根延长和侧壁厚度的数据。采用方差分析比较三组患者术前及术后12个月的派评分均值。如果有统计学意义，则进行Bonferroni检验以比较三组之间的结果。显著性水平设为p
Introduction: Treatment of a tooth with necrotic pulp and open apex is a special challenge to the clinicians. Apexification with calcium hydroxide and MTA barrier technique fails to induce continued root maturation which makes the tooth susceptible to root fracture. Hence, an ideal outcome for such a tooth should be regeneration of pulp like tissue into the root canal capable of continuing normal root maturation.Aim: This study aims to compare the effect of Platelet Rich Fibrin (PRF), induced bleeding technique and Platelet Rich Plasma (PRP) in the revascularization of tooth with necrotic pulp and open apex. The main objectives of the study were to: (a) Radiographically evaluate the continuation of root development, increase in the dentin wall thickness and narrowing of canal space, apical closure and resolution of the periapical lesion; and to (b) To clinically evaluate the response to pulp sensibility testing and response to percussion and palpation tests.Materials and Methods: Sixty patients (6 to 28 years) with necrotic immature permanent tooth were randomly categorised into three groups after the root canal disinfection procedure. PRF as scaffolding material (Group A: n=20), revascularization with conventional induced bleeding technique (Group B: n=20), and PRP as the biomaterial (Group C: n=20). The primary outcome variable was measured using Periapical Index (PAI) (for periapical healing), Chen and Chen index (for apical responses), Schei's ruler (for root lengthening and root thickening) and other clinical parameters. The Chi-square test was used to interpret the data among the three groups at the end of 12 months for the variables root lengthening and lateral wall thickness. ANOVA test was performed to compare the mean of the PAI scores of the three groups at preoperative stage and 12 months. If statistically significant, Bonferroni test was done to compare the outcome among the three groups. The significant level was set at p