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Published on: August 6, 2019
Comparing 2 Different Scaffolds in Regenerative Endodontics of Mature Teeth with Apical Periodontitis: A Randomised
Neelam Mittal1, Harakh Chand Baranwal1, Burugupalli Swetha1
1Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Banaras Hindu University, Varanasi, India.
Aim:
This randomised clinical study assessed and compared the healing outcomes, both clinical and radiographic, of platelet-rich fibrin (PRF) and human amniotic membrane (HAM) scaffolds in regenerative endodontic therapy for necrotic mature permanent teeth with apical periodontitis.
Methodology:
The study protocol was registered on the Clinical Trial Registry (CTRI/2023/12/060979). Thirty participants presenting with necrotic mature permanent teeth and apical lesions were assigned to either the PRF or HAM group (n=15 each) randomly. Follow-up evaluations were performed at baseline, 6 months, and 12 months, with clinical assessments and periapical radiographs conducted at all 3 time points, while cone-beam computed tomography (CBCT) imaging was obtained at baseline and at 12 months. Standardised regenerative endodontic procedures were performed by a single operator. Examiner calibration was completed prior to data collection to ensure consistency in measurements.
Results:
At the 12-month follow-up, both groups demonstrated favourable clinical outcomes, with resolution of symptoms and radiographic evidence of periapical healing. The CBCT analysis revealed significant reductions in lesion volume for both PRF (65.26%) and HAM (64.75%) groups (P < .005), without a statistically significant difference between the groups. Periapical healing scores improved similarly in both groups. Sensibility tests revealed no return of pulp responsiveness in any case throughout the study period.
Conclusion:
Both PRF and HAM scaffolds supported periapical healing in necrotic mature permanent teeth. However, biological regeneration of the functional pulp-dentin complex could not be confirmed, indicating that periapical healing occurred without verified neurovascular re-establishment. The restricted sample size and limited follow-up duration suggest the need for further studies with larger populations and extended observation periods to substantiate these findings.
