Endodontic repair in immature dogs' teeth with apical periodontitis: blood clot vs plasma rich in growth factors scaffold.
OBJECTIVE
Different types of scaffolds have been suggested for endodontic repair procedures. The aim of this study was to compare the outcome of procedures using blood clot vs plasma rich in growth factors (PRGF) scaffold in immature teeth with apical periodontitis in dogs.


METHODS
In this in vivo animal study, 20 teeth (30 canals) with open apices were divided into two groups (n = 12): (1) blood clot and (2) PRGF. Two positive and negative control groups were also selected randomly. After exposing the pulp and inducing periapical inflammation by placing a sponge soaked in a suspension of dental plaque, the root canals of both groups were flushed with sodium hypochlorite and filled with triple antibiotic paste. After 28 days, the antibiotic mixture was removed, bleeding was induced through the apical foramen, and mineral trioxide aggregate was placed over the blood clot in group one and PRGF scaffold in group two. Access cavities were then filled with composite resin. The radiographic and histological findings were compared immediately after the procedure, as well as after 3 and 6 months of follow-up.


RESULTS
There was no statistically significant difference between the two experimental groups with regard to the radiographic or histological results (P > 0.05). The incidence of healed periapical radiolucency was 60% and 53.33% in groups one and two, respectively. Apical closure was noted in 60% of samples in both experimental groups. New cementum-like tissue formation was detected along the walls of the canals, and bone-like islands within the canals were also observed.


CONCLUSIONS
Plasma rich in growth factors scaffold showed no advantage over blood clots regarding healing of the periapical radiolucency, radiographic apical closure and type of the newly formed soft and hard tissues.
Iranian Center for Endodontic Research, Research Institute of Dental Science, Endodontic Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Omid
O
Dianat
Pathology Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Fatemeh
F
Mashhadi Abas
Endodontic Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Payam
P
Paymanpour
Iranian Center for Endodontic Research, Research Institute of Dental Sciences Endodontic Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohammad Jafar
MJ
Eghbal
Orthodontic Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sahar
S
Haddadpour
Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nazanin
N
Bahrololumi
D017607:Aluminum Compounds; D000818:Animals; D001777:Blood Coagulation / Q000502:physiology*; D017610:Calcium Compounds; D004285:Dogs; D004338:Drug Combinations; D036341:Intercellular Signaling Peptides and Proteins / Q000494:pharmacology*; D010087:Oxides; D010485:Periapical Periodontitis / Q000628:therapy*; D053657:Platelet-Rich Plasma; D017640:Silicates; D012973:Sodium Hypochlorite; D054457:Tissue Scaffolds; D019227:Tooth Apex
D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D036341:Intercellular Signaling Peptides and Proteins; D010087:Oxides; D017640:Silicates; C086631:mineral trioxide aggregate; D012973:Sodium Hypochlorite
apical periodontitis; endodontic repair; immature permanent teeth; plasma rich in growth factors; scaffold