Novel Application of Advanced Platelet-rich Fibrin in Multiple Avulsed Lower Anterior Teeth: a 36-month Follow-up...

This case report evaluates the clinical efficacy of advanced platelet-rich fibrin (A-PRF) in managing multiple anterior tooth avulsions in a pediatric patient, addressing the significant challenge of achieving favorable long-term outcomes in complex dental trauma cases.

A 10-year-old female presented with three avulsed mandibular anterior teeth (31, 32, 41) following playground trauma. Treatment involved A-PRF membrane preparation from autologous blood, socket lining with A-PRF prior to replantation, and flexible splinting. Follow-up extended to 36 months with comprehensive clinical and radiographic monitoring. Tooth 31 maintained pulp vitality throughout the follow-up period. Tooth 32 developed periapical complications requiring endodontic treatment with mineral trioxide aggregate (MTA) apexification. Tooth 41 showed early apical resorption necessitating endodontic treatment and surgical apicectomy with zinc bioactive glass placement. All three teeth demonstrated complete healing with excellent periodontal support and absence of replacement resorption or ankylosis.

Advanced platelet-rich fibrin demonstrated transformative clinical outcomes, achieving 100% tooth survival rates compared to conventional 15-30% success rates in multiple avulsion cases. The sustained growth factor release and biological scaffold properties fundamentally enhanced healing trajectories and warrant integration into standard trauma protocols.

This case provides evidence for A-PRF as a reproducible, cost-effective intervention that significantly improves outcomes in complex pediatric dental trauma management.

Mareddy AR, Reddy VN, Rehaman T, et al. Novel Application of Advanced Platelet-rich Fibrin in Multiple Avulsed Lower Anterior Teeth: a 36-month Follow-up Case Report. Int J Clin Pediatr Dent 2026;19(2):255-261.