Restor Dent Endod.  2014 Feb;39(1):51-55.

Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion

• Goyal L

Abstract

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

Keyword

Bone graft; Bone regeneration; Platelet rich fibrin

MeSH Terms

Blood Platelets*
Bone Regeneration
Bone Substitutes*
Dental Pulp Cavity
Endodontics
Fibrin*
Follow-Up Studies
Humans
Incisor
Intercellular Signaling Peptides and Proteins
Male
Periodontium
Transplants
Wound Healing
Bone Substitutes
Fibrin
Intercellular Signaling Peptides and Proteins

Figure

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  Figure 1 Preoperative view of discoloured maxillary lateral incisor.

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  Figure 2 Preoperative radiograph showing radiolucency along distal aspect of maxillary lateral incisor to the apex.

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  Figure 3 Separation of platelet rich plasma from the collected autologous blood.

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  Figure 4 Platelet rich fibrin after activation with calcium chloride.

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  Figure 5 Curettage of the defect after reflection of soft tissue flap using intracrevicular incision.

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  Figure 6 Placement of graft into defect.

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  Figure 7 Placement of PRF.

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  Figure 8 Follow-up radiographs (a) at 6 months, postoperative view showing bone fill; (b) at 12 months.

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