Pulp Revascularization of Immature Dog Teeth with Apical Periodontitis Using Triantibiotic Paste and Platelet-rich Plasma: A Radiographic Study

• Modified triple antibiotic paste and platelet-rich plasma in revascularization provide better radiographic results.
• Intracanal dressing of triple antibiotic paste and the use of platelet-rich plasma as the scaffold improves the success rate of the revascularization procedure.

IntroductionThis study evaluates radiographically the efficacy of 4 revascularization protocols in necrotic-infected immature dog teeth with apical periodontitis (AP).MethodsForty double-rooted immature premolar teeth from 4 female beagle dogs aged 5 months were used. Four teeth were left untouched as negative controls; the other 36 teeth were infected to develop pulp necrosis and AP following different treatment protocols. Four teeth were left untreated and assigned to the positive control group, and the last 28 teeth were randomly assigned into 4 experimental groups of 8 teeth: A1, sodium hypochlorite (NaOCl) + a blood clot; A2, NaOCl + platelet-rich plasma (PRP); B1, NaOCl + modified triantibiotic paste (mTAP) + a blood clot; and B2, NaOCl + mTAP + PRP. Teeth were monitored radiographically for 6 months regarding healing of periapical radiolucencies, thickening of the dentinal walls, and apical closure of roots.ResultsSignificant differences (P < .05) between the 4 groups were evident in the percentage of teeth showing improvement of periapical radiolucencies (62.5%), continued radiographic thickening of radicular walls (53.1%), radiographic apical closure (43.8%), and deposition of hard tissue on radicular dentin walls (53.1%). Group B2 showed maximal improvement in the 3 variables assessed (P < .05). Group A1 showed the minimum percentages in the 3 parameters assessed (P < .05).ConclusionsThese results suggest that an intracanal dressing of mTAP and the use of PRP as scaffold improves the success rate of the revascularization procedure.