Browse > Article
http://dx.doi.org/10.5933/JKAPD.2013.40.3.216

Pulp Revascularization of Infected Immature Permanent Teeth Using Platelet-Rich Fibrin and Double Antibiotic Paste : Case Report  

Jeon, Sang-Yun (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)
Publication Information
Journal of the korean academy of Pediatric Dentistry / v.40, no.3, 2013 , pp. 216-222 More about this Journal
Abstract
Paradigm shift in management of infected immature permanent teeth has occurred. The new concept of the treatment includes minimal or no intracanal instrumentation, disinfection with triple antibiotic paste and sealing with mineral trioxide aggregate. This regenerative endodontic treatment promotes differentiation of periradicular stem cells that induce regeneration of vital tissue and continuation of root formation. Thorough disinfection and three-dimensional scaffold are important in this new concept of the treatment. Platelet-rich fibrin has been reported as 'new scaffold' instead of blood clot, which had been used in the past. Triple antibiotics can be used to disinfect the tooth but may lead to complications including discoloration. Three cases of infected immature permanent tooth caused by dens evaginatus fracture are presented. After removal of necrotic pulp and thorough intracanal irrigation, only platelet-rich fibrin was applied to the root canal in the first case. In the other cases, topical antibiotics was used for disinfection and platelet-rich fibrin for scaffold. In all the cases, the opening was sealed with mineral trioxide aggregate. All the cases showed proper healing of inrabony lesion and some lengthening of root. According to these cases, regenerating vital tissue of the infected immature permanent tooth can be achieved with disinfection and application of platelet-rich fibrin.
Keywords
Pulp revascularization; Platelet-rich fibrin; Immature permanent tooth;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Treatment outcome with a revascularization protocol using the triple versus double antibiotic paste. ClinicalTrials.gov. Available from URL. http://clinicaltrials.gov/ct2/show/NCT00881491 (Accessed on June 11, 2013)
2 Kim JH, Kim YR, Jung IY, et al. : Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod, 36:1086-1091, 2010.   DOI   ScienceOn
3 Jacobovitz M, de Lima RK : Treatment of inflammatory internal root resorption with mineral trioxide aggregate: a case report. Int Endod J, 41:905-912, 2008.   DOI   ScienceOn
4 Belobrov I, Parashos P : Treatment of tooth discoloration after the use of white mineral trioxide aggregate. J Endod, 37:1017-1020, 2011.   DOI   ScienceOn
5 Smith AJ : Vitality of the dentin-pulp complex in health and disease: growth factors as key mediators. J Dent Edu 67:678-89, 2003.
6 Hu CC, Zhang C, Qian Q, Tatum NB : Reparative dentin formation in rat molars after direct pulp capping with growth factors. J Endod, 24:744-51, 1998.   DOI   ScienceOn
7 Sloan AJ, Smith AJ : Stimulation of the dentinepulp complex of rat incisor teeth by transforming growth factor beta isoforms 1-3 in vitro. Arch Oral Biol, 44:149-56, 1999.   DOI   ScienceOn
8 Joseph C, Antoine D, David MD et al. : Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part IV: Clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 101:E56-60, 2006.   DOI   ScienceOn
9 Huang GTJ : Apexification : the beginning of its end. Int Endod J, 42:855-866, 2009.   DOI   ScienceOn
10 Iwaya S, Ikawa M, Kubota M : Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol 17:185-187, 2001.   DOI   ScienceOn
11 Banchs F, Trope M : Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod, 30:196-200, 2004   DOI   ScienceOn
12 Murray PE, Garcia-Godoy F, Hargreaves KM : Regenerative endodontics: a review of current status and a call for action. J Endod, 33:377-390, 2007.   DOI   ScienceOn
13 Choukroun J, Diss A, Dohan DM, et al. : Plateletrich fibrin (PRF): A second-generation platelet concentrate. Part IV: Clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 101:e56-60, 2006.   DOI   ScienceOn
14 Thibodeau B, Trope M : Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatr Dent 29:47-50, 2007.
15 Basma D, Emanuel A, Stephane S, et al. : Clinical complications in the revascularization of immature necrotic permanent teeth. Pediatr Dent, 34:414-7, 2012.
16 Huang FM, Yang SF, Zhao JH, Chang YC : Platelet-rich fibrin increases proliferation and differentiation of human dental pulp cells. J Endod, 36:1628-1632, 2010.   DOI   ScienceOn
17 Hiremath H, Saikalyan S, Kulkarni SS, Hiremath V : Second-generation platelet concentrate (PRF) as a pulpotomy medicament in a permanent molar with pulpitis: a case report. Int Endod J, 45:105-112, 2012.   DOI   ScienceOn
18 Shivashankar VY, Johns DA, Vidyanath S, Kumar MR : Platelet rich fibrin in the revitalization of tooth with necrotic pulp and open apex. J Conserv Dent 15:395-8, 2012.   DOI   ScienceOn
19 Ambica K, Sarika C, Sangeeta T, Mahesh V : Endodontic management of single rooted immature mandibular second molar with single canal using MTA and platelet-rich fibrin membrane barrier: a case report. J Clin Exp Dent, 3:e487-90, 2011.