Histological Findings of Revascularized/Revitalized Immature Permanent Molar with Apical Periodontitis Using Platelet-rich Plasma

• Published in: Journal of endodontics Vol. 39; no. 1; pp. 138 - 144
• Main Authors: Martin, Gabriela, DDS, Ricucci, Domenico, MD, DDS, Gibbs, Jennifer L., MAS, DDS, PhD, Lin, Louis M., BDS, DMD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2013
• Subjects: Aluminum Compounds - therapeutic use; Apexification - methods; Apical periodontitis; Blood; Bone Matrix - pathology; Calcium Compounds - therapeutic use; cementoid/osteoid tissue; Child; Connective Tissue - pathology; Dental Cementum - pathology; Dental Pulp Necrosis - therapy; Dentin - pathology; Dentistry; Drug Combinations; Endocrinology & Metabolism; Follow-Up Studies; Humans; immature permanent tooth; Male; Molar - injuries; Molar - pathology; Oxides - therapeutic use; Periapical Periodontitis - therapy; platelet-rich plasma; Platelet-Rich Plasma - physiology; revascularization/revitalization; Root Canal Filling Materials - therapeutic use; Root Canal Irrigants - therapeutic use; Root Canal Preparation - methods; Silicates - therapeutic use; Tooth Apex - pathology; Tooth Extraction; Tooth Fractures - therapy; revascularization/revitalization; Apical periodontitis; immature permanent tooth; cementoid/osteoid tissue; platelet-rich plasma
• ISSN: 0099-2399; 1878-3554
• DOI: 10.1016/j.joen.2012.09.015

Abstract Introduction An immature mandibular right first molar (#30) with apical periodontitis of a 9-year-old boy was treated with a revascularization/revitalization procedure using either a mixture of platelet-rich plasma (PRP) and a blood clot or a blood clot alone on the same tooth. Methods Tooth #30 fractured 2 years and 1 month after the revascularization/revitalization procedure and could not be saved. The tooth was extracted and processed for histologic examination to determine the nature of the tissues that formed in the canals. Results Clinically, the endodontic treatment of the case was successful based on the resolution of apical periodontitis and the absence of clinical signs and symptoms. Histologically, the tissues formed in the distal and mesial canals were mineralized tissue similar to cementoid/osteoid tissue and uninflamed fibrous connective tissue regardless of PRP or no PRP treatment. No pulp-like tissue characterized by the presence of odontoblast-like cells polarized along the dentin-like mineralized tissue was observed. Conclusions The tissues formed in the canals were mineralized tissue and some fibrous connective tissue. No pulp-like tissue characterized by the presence of odontoblast-like cells was observed lining the dentin-like mineralized tissue.