Platelet-rich fibrin and hydroxyapatite in management of peripical inflammatory lesions: a comparative clinical analysis

Aim and Objectives: To evaluate bone regeneration in periapical lesions using MTA as retrograde filling of material with or without Hydroxyapatite and Platelet-Rich fibrin(PRP), and a combination of Hydroxyapatite and Platelet-Rich fibrin in curetted periapical defects and evaluate the patients clinically at each recall visit.
Materials and Methods: Thirty healthy patients of both genders, ages 20 and 40 years were included. the patient had to have a tooth where root canal therapy had failed and having periapical radiolucency, and periapical root end surgery was required. Patients were divided into three groups, with ten patients each, as follows: Group I — root end cavity was filled with MTA. Group II — root end cavity was filled with MTA followed by placement of hydroxyapatite in the curetted periapical defect., Group III — root end cavity was filled with MTA followed by placement of PRF in the curetted periapical defect.. The patients were followed clinically and radiographically. In all the three groups, patient recall visits were scheduled after 1, 3, 6, and 9 months time interval for clinical and radiological examination.
Results: A healing was observed after 9 months in Group III followed by Group II and Group I. The clinical and .radiographic evaluation revealed that Group III (82.36%) patients showed significantly higher rate of bone regeneration with evidence of a trabecular pattern, at the end of 9 months followed Group II (65.16%) ,then Group I (60.12%).
Conclusions: Root end filling material contributes greatly to the success of surgical treatment and to improve healing of periapical defect we use host modulating agents such as PRF over grafts as these are autologous and contain growth factors which promote faster healing of periapical defects.