title: Second-generation Platelet Concentrate (Platelet-rich Fibrin) as a Scaffold in Regenerative Endodontics: A Case Series.
abstract: BACKGROUND
  The purpose of this case series was to report the clinical and radiographic results of a pulp regenerative procedure using platelet-rich fibrin (PRF), a second-generation platelet concentrate, in immature teeth with necrotic pulps.
  
  
  METHODS
  Root canal revascularization using PRF was performed on 4 immature teeth with necrotic pulps. After access cavity preparation, the root canals were irrigated with low concentration sodium hypochlorite solution (1.5% sodium hypochlorite [20 mL/canal, 5 minutes]) and then irrigated with saline (20 mL/canal, 5 minutes). Equal proportions (167 mg) of ciprofloxacin, metronidazole, and cefaclor were mixed and diluted to a final concentration of 1 g/mL. Finally, the canal was sealed with 3-4 mm of a temporary restorative material, and patients were dismissed for 2 to 3 weeks. At the second appointment, 9 mL of the patient's whole blood was obtained and centrifuged to prepare a PRF clot. Canals were irrigated with 17% EDTA, and a sharp spreader was inserted beyond the apex. Then, the PRF clot was placed inside the root canals, and Biodentine (Septodont, Saint-Maur, France) was placed directly over the PRF. The teeth were restored permanently with glass ionomer cement and composite resin.
  
  
  RESULTS
  Clinical examinations revealed that all cases were asymptomatic at the recall appointments at 1, 3, 6, 12, and 18 months. Radiographs revealed resolution of the periapical lesions, further root development, and apical closure in all cases.
  
  
  CONCLUSIONS
  On the basis of the short-term results up to 12 months, PRF clots acted as successful scaffolds for the regeneration of pulpal contents in immature teeth with necrotic pulps.
authors.affiliation: Dental Material Research Center, Tehran Dental Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Hengameh
authors.initials: H
authors.lastname: Bakhtiar
authors.affiliation: Dental Material Research Center, Tehran Dental Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Esmaeili
authors.affiliation: Dental Material Research Center, Tehran Dental Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Setareh
authors.initials: S
authors.lastname: Fakhr Tabatabayi
authors.affiliation: Dental Material Research Center, Tehran Dental Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Ellini
authors.affiliation: Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran; Endodontology Research Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK. Electronic address: Nekoofarmh@cardiff.ac.uk.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Nekoofar
authors.affiliation: Endodontology Research Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
authors.forename: Paul M H
authors.initials: PM
authors.lastname: Dummer
mesh_terms: D000293:Adolescent; D002648:Child; D003786:Dental Pulp Cavity / Q000098:blood supply* / Q000502:physiology; D003790:Dental Pulp Necrosis / Q000628:therapy*; D004708:Endodontics; D005260:Female; D006801:Humans; D008297:Male; D010482:Periapical Abscess / Q000628:therapy*; D000073183:Platelet-Rich Fibrin; D012038:Regeneration; D012390:Root Canal Therapy / Q000379:methods
keywords: Open apex; platelet-rich fibrin; regenerative endodontics; revascularization; second-generation platelet concentrate