Endodontic regeneration treatment in vital and necrotic pulp, using platelet-rich fibrin and Biodentine
a case report
Keywords:
Endodontic regeneration, Pulp necrosis, Irreversible pulpitis, Platelet rich fibrin;, BiodentineAbstract
Endodontic regeneration is an inductive and reparative biological treatment indicated to replace cell damage at the level of the dentinopulp complex. The objective of this study is to report a case of Endodontic Regenerative Therapy, in young permanent first molars, in a 10-year-old patient, using platelet-rich fibrin and Biodentine, applying two different protocols for combined diagnoses of irreversible pulpitis and pulp necrosis. The patient attended consultation due to extensive carious lesions. Clinical and imaging evaluations (X-rays and Cone Beam) were performed. The protocol in the necrotic canal consisted of disinfection with a bi-antibiotic paste and placement of a second-generation autologous scaffold matrix, made of biodegradable platelet-rich fibrin which is also , biocompatible and therefore without risk of immune rejection. The protocol in the canals with irreversible pulpitis consisted in a complete pulpotomy and placement of Biodentine calcium silicate cement, a material considered as first choice for pulp-conserving treatments, with properties similar to dentin. Eight weeks after the end of the treatment, a clinical control was conducted revealing an asymptomatic chart and negative palpation without the presence of fistula or abscess. This result indicated regeneration of the pulp tissues and success of the applied protocols. Controls will be carried out at 6, 12 and 18 months. Conclusion: The application of endodontic regenerative treatments, as performed in this reported case, is a favorable and innovative option to preserve, restore or replace the dental pulp. In comparison with conventional treatments, this procedure allows to return pulp functionality, complete development of the root, thickening of the dentinal walls and closure of the apical foramen of young permanent teeth affected by pulp pathologies. It is important that regenerative therapies are publicized and applied by dental professionals
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