Int Endod J. 2022 Dec 24. doi: 10.1111/iej.13886. Online ahead of print.
ABSTRACT
INTRODUCTION: Regenerative endodontic procedures have been recently suggested as a treatment of mature permanent teeth with peri-apical periodontitis due to favorable outcomes in the resolution of signs and symptoms and the healing of apical periodontitis. Most of the randomized clinical trials were conducted for anterior teeth rather than mature molar teeth.
AIM: To evaluate the postoperative pain and the healing of necrotic mature permanent mandibular molar teeth with peri-apical periodontitis after conventional endodontic treatment versus after PRP revascularization.
METHODS: The protocol of this randomized clinical trial was registered at www.
CLINICALTRIALS: gov with identification number NCT03350841. Twenty-eight patients were included in the study after confirming the diagnosis clinically and radiographically. In the first visit, the mandibular molar teeth of both groups were mechanically prepared. The double antibiotic paste was injected into the canals and the cavity was sealed using glass ionomer. At the second visit, the patients were randomized either to the control group where the endodontic treatment was completed by lateral condensation technique or assigned to the intervention group where PRP revascularization was used. The degree of spontaneous pain was assessed using a numerical rating scale (NRS) pre-operatively, then post-operatively after 6, 12 hours and daily for 5 days. Patients were given a placebo to be administrated in case of pain. An analgesic (ibuprofen 400mg) was prescribed in case of persistent pain. Clinical and radiographic healing was assessed after 6 and 12 months. All demographic, baseline and outcome data were statistically analyzed.
RESULTS: Regarding the post-revascularization/ obturation pain, there was no statistically significant difference between the severity of pain in the two groups at all time intervals except after 12 hours, revascularization group showed a statistically significantly higher prevalence of no pain than the endodontic treatment group. Regarding the healing; the peri-apical lesions decrease in size significantly from the pre-operative lesion size in both groups without significant difference.
CONCLUSION: Both PRP revascularization and endodontic treatment resulted in a significant reduction in peri-apical lesion size related to mature necrotic mandibular molar teeth but further randomized clinical trials with standardized techniques, larger sample sizes and longer follow-up periods are recommended.
PMID:36565044 | DOI:10.1111/iej.13886
