Novel Treatment of Apical Periodontitis Using PRF in Mature Teeth.

Objectives: The aim of the present study is to evaluate the effectiveness of platelet rich fibrin (PRF) revascularization technique clinically and radiographically for the treatment of apical periodontitis in permanent teeth with closed apex, and assessment of regaining tooth sensitivity. In addition the study evaluated the periapical healing by measuring the changes in periapical radiolucency size using CBCT software imaging.
Methods: A total of 15 patients with apical periodontitis in permanent central incisors were included in the study. Regenerative disinfection protocol was carried on using 1.5 % sodium hypochlorite irrigation and double antibiotic paste intra-canal medicament for 3 weeks. After ensuring the resolution of signs and symptoms, bleeding was induced inside the canal, followed by PRF scaffold application inside the canal space. Finally MTA was applied directly over PRF, followed by glass ionomer and composite-resin restoration. Clinical and radiographic evaluation was done for1, 3, 6, 9, and 12 months, and CBCT imaging was done after 6, 12 month follow-up period.
Results: It showed 100% clinical success as complete resolution of the signs and symptoms were observed through the follow up period. 60 % of the cases showed regaining of tooth sensitivity. CBCT imaging at 6, 12 month showed a highly statistically significant difference concerning the decrease in lesion size.
Conclusions: PRF revascularization is an effective treatment of apical periodontitis in permanent teeth with closed apex.