Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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REGENERATIVE ENDODONTIC TREATMENT OF IMMATURE PERMANENT TEETH BY USING PLATELET-RICH FIBRIN

치근단 병변이 있는 미성숙 영구치에서 Platelet-rich fibrin(PRF)를 이용한 보존적 근관치료

  • Kim, Ha-Na (Department of Pediatric Dentistry, College of Dentistry, Chosun University) ;
  • Lee, Nan-Young (Department of Pediatric Dentistry, College of Dentistry, Chosun University) ;
  • Lee, Sang-Ho (Department of Pediatric Dentistry, College of Dentistry, Chosun University)
  • 김하나 (조선대학교 치과병원 소아치과학교실) ;
  • 이난영 (조선대학교 치과병원 소아치과학교실) ;
  • 이상호 (조선대학교 치과병원 소아치과학교실)
  • Received : 2012.02.06
  • Accepted : 2012.05.10
  • Published : 2012.05.31
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Abstract

In case of an immature tooth with necrotic pulp, regeneration of pulp tissue into a canal would be the ideal outcome. It may be capable of promoting the continuation of normal root development. Platelet-rich fibrin has been suggested as a potentially ideal scaffold for regenerative endodontic treatment. Immature permanent teeth of young children were diagnosed with pulp necrosis and apical abscess as the result of clinical and radiographic examination. After removal of necrotic pulp, canal was irrigated with 5.25% NaOCl and dried with paper point. A triple antibiotic mixture was placed in canal space in 3 weeks. After removal of the antibiotic mixture, the platelet-rich fibrin was injected into the canal space with MTA placed directly over the platelet-rich fibrin clot. The coronal region was restored by composite resin. On the basis of short-term results of the present 3 cases, regeneration of vital tissues appears to be possible in a tooth with necrotic pulp and a periapical lesion. Also, platelet-rich fibrin proves to be potentially an ideal scaffold for this procedure. Therefore, long-term clinical observation and examination about this treatment using platelet-rich fibrin in immature permanent teeth of young children are considered to be necessary.

성장 중인 아동에서는 치근의 성장이 계속됨에 따라 치수가 괴사되어 치근의 병변이 있는 미성숙 영구치에서도 치수의 재혈관화가 실제로 일어날 수 있다는 가능성이 제시 되고 있다. 치수의 재혈관화를 위해서는 근관 내의 감염의 조절과 함께 적절한 scaffold가 필요하며, platelet-rich plasma(PRP)가 이상적인 scaffold로 제시되었다. 최근 임상에서는 PRP의 단점을 극복한 platelet-rich fibrin(PRF)가 응용되고 있다. 본 증례에서는 치외치의 교두 파절로 인한 치수 감염으로 치근단 병변을 가진 미성숙 영구치의 근관 내에 ciprofloxacin, metronidazole, minocycline의 세 가지 항생제 적용 후 이와 함께 PRF를 적용하였다. 정기적인 검진 결과 치근단 병변의 치유와 함께 치근 성장이 관찰되었다. 이러한 보존적인 근관 치료는 미성숙 영구치에서 치근단 형성술의 대안적인 치료로서 이용될 수 있을 것이며, 향후 장기간의 임상적 관찰이 필요할 것이다.

Keywords

References

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