COMPARATIVE ANALYSIS OF PLATELET-RICH FIBRIN AND HYDROXYAPATITE IN MANAGEMENT OF PERIPICAL INFLAMMATORY LESIONS: A CLINICAL AND RADIOGRAPHIC ANALYSIS

Abstract

Aim and Objectives:  To  evaluate bone regeneration in  periapical lesions using MTA  as retrograde filling of material with or without Hydroxyapatite and Platelet-Rich fibrin(PRP), and a combination of Hydroxyapatite and Platelet-Rich fibrin in curetted periapical defects and evaluate the patients clinically at each recall visit.

Materials and Methods:  Thirty systemically healthy patients of both genders between the ages 20 and 40 years were included. To  qualify, the patient had to have a tooth where non-surgical root canal therapy had failed, periapical radiolucency was present, and periapical root end surgery was required. The bony defect had to be confined to the apical area, with the bone covering the entire root surface coronally, with an intact lingual cortical plate. Patients were randomly divided into three groups, with ten patients each, as follows: Group I — root end cavity was filled with MTA. Group II — root end cavity was filled with MTA followed by placement of hydroxyapatite in the curetted periapical defect., Group III — root end cavity was filled with MTA followed by placement of PRF in the curetted periapical defect.. The patients were evaluated both clinically and radiographically. In all the three groups, patient recall visits were scheduled after 1, 3, 6, and 9 months time interval for clinical and radiological examination.

 Results:  A healing was observed after 9 months in Group III followed by Group II and Group I. The clinical and .radiographic evaluation revealed that Group III (82.36%) patients showed significantly higher rate of bone regeneration with evidence of a trabecular pattern, at the end of 9 months followed Group II (65.16%) ,then Group I (60.12%).

Conclusions:  Placement of root end filling material contributes greatly to the success of surgical treatment. To enhance the healing of periapical defect, use of host modulating agents such as PRF is preferred over grafts as these are autologous and contain growth factors that promote faster healing of periapical defects.

Keywords:  Bone Regeneration; hydroxyapatite; periapical lesion; platelet-rich fibrin, MTA