Acute Apical Periodontitis of Pulpal Origin, Chronic Apical Periodontitis, Necrosis of Pulp, Periapical Abscess
Conditions
Keywords
PRF, regenerative endodontic treatment, mature permanent treatment
Brief summary
This study aims to evaluate the antibacterial effects of injectable platelet-rich fibrin (i-PRF) in vitro, and to assess the clinical and radiographic outcomes of using advanced platelet-rich fibrin (A-PRF+) and i-PRF in regenerative endodontic treatment of mature permanent teeth with necrotic pulp. The study will compare the effectiveness of PRF-based treatment with conventional blood clot-based regenerative endodontics.
Detailed description
This study aims to evaluate the antibacterial effects of injectable platelet-rich fibrin (i-PRF) in vitro, and to assess the clinical and radiographic outcomes of using advanced platelet-rich fibrin (A-PRF+) and i-PRF in regenerative endodontic treatment of mature permanent teeth (single-rooted teeth with necrotic pulp, with or without periapical pathology). The study will compare the effectiveness of PRF-based treatment with conventional blood clot-based regenerative endodontics.
Interventions
PROCEDUREUsing advanced platelet-rich fibrin (A-PRF+) or injectable platelet-rich fibrin (i-PRF) in regenerative endodontic treatment in mature permanent teeth.
After obtaining informed consent, the study will be conducted over 2 appointments, 2-4 weeks apart. The first appointment will focus on infection control and inflammation reduction. The canal will be instrumented with a single-file system. The canal will be then irrigated sequentially with 3% sodium hypochlorite (NaOCl), saline, and 17% ethylenediaminetetraacetic Acid (EDTA) to ensure thorough disinfection. Finally, a temporary filling of Glass Ionomer Cement will be placed over an intracanal dressing of calcium hydroxide. At the second appointment, the final treatment will be performed based on the patient's group: Control Group - Blood clot method for regenerative endodontics. Experimental Group 1 - Regenerative endodontics using advanced platelet-rich fibrin (A-PRF+). Experimental Group 2 - Regenerative endodontics using injectable platelet-rich fibrin (i-PRF). All three groups will be then sealed with mineral trioxide aggregate (MTA) and a final composite resin filling.
Sponsors
Odonto-Maxillo Facial Hospital in Ho Chi Minh City
University of Medicine and Pharmacy at Ho Chi Minh City
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Control Group - Blood clot method for regenerative endodontics. Experimental Group 1 - Regenerative endodontics using advanced platelet-rich fibrin (A-PRF+). Experimental Group 2 - Regenerative endodontics using injectable platelet-rich fibrin (i-PRF).
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Participants had a single-rooted tooth with necrotic pulp (negative response to electric pulp testing), with or without periapical pathology (acute apical periodontitis of pulpal origin, chronic periapical periodontitis, periapical abscess with sinus, periapical abscess without sinus), and gave their consent to participate in the study.
Exclusion criteria
Study samples will be excluded if any of the following criteria are met: * The tooth has had previous endodontic treatment. * The root apex is not fully developed, or there is root resorption/cracking/fracture. * The tooth has severe tooth loss and is indicated for extraction, or is indicated for restoration with a post or cast core after endodontic treatment. * The root canal is calcified. * The root canal curvature is greater than 25º. * The tooth has a periapical cyst or is associated with a jawbone cyst. * The tooth has a periodontal pocket deeper than 4 mm. * The tooth has no occlusal contact. * The patient is pregnant. * The patient has diabetes or HIV or other immunocompromised conditions.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical assessment | 1 month, 3 months, 6 months, 9 months, 12 months. | * Clinical success: Absence of all the following symptoms (swelling, sinus tract, pain on percussion/bite, tooth mobility, and positive pulp sensibility). * Clinical failure: Presence of any one of the above symptoms. |
| Radiographic assessment | 1 month, 3 months, 6 months, 9 months, 12 months | * Radiographic success: Absence or reduction of periapical pathology, measured by change in lesion size on periapical radiographs/CBCT. * Radiographic failure: Persistence or progression of periapical pathology, measured by change in lesion size on periapical radiographs/CBCT. |
Countries
Vietnam
Contacts
Primary ContactVI THI TUONG TRAN, Master of Science
Outcome results
None listed