Yoshpe Margarita*, Shahar Ohad and Kaufman Y. Arieh
Regenerative Endodontic Procedures (REP) are used to treat apical periodontitis in immature necrotic teeth and promote root maturation. Recently, REP has been speculated to arrest inflammatory external root resorption. Herein, we report the complicated treatment of apical root fracture using Plasma-Rich Fibrin (PRF) in a 12-year-old boy with a history of trauma to the right maxillary central incisor. The tooth was diagnosed to have necrotic pulp accompanied by symptomatic apical periodontitis and was treated with REP using PRF as a scaffold and restored. The tooth was asymptomatic at the 9-month follow-up; however, a sinus tract was detected on the buccal side. Retreatment was performed, and the tooth was filled with an apical plug of mineral trioxide aggregate and gutta-percha. Following the root canal, an apicoectomy was performed. During the surgery, a Vertical Root Fracture (VRF) was detected on the lateral aspect of the root extending to the middle third. The surface of the fracture was cleaned meticulously with a high-speed fine round diamond bur. The VRF was covered with PRF mixed with autologous bone. A
follow-up at 57 months revealed a symptomless functioning tooth. This case highlights the importance of making every acceptable effort to preserve a hopeless tooth with VRF in a youngster for a few years and thereby preserve the surrounding alveolar bone.
