Effect of injectable platelet rich fibrin augmented with vitamin c compared to injectable platelet rich fibrin alone on healing of necrotic mature single rooted teeth with chronic periapical periodontitis following regenerative endodontic therapy (a randomized controlled trial).

Abstract

Objectives: To assess the healing potential, postoperative pain and clinical normalcy associated with injectable platelet-rich fibrin combined with Vitamin C in regenerative endodontic procedure using cone-beam computed tomography and two-dimensional radiograph.

Methods: Twenty-eight healthy patients with mature permanent single-rooted teeth diagnosed with pulp necrosis and chronic apical periodontitis were randomly allocated into two groups (n = 14). Regenerative endodontic treatment was performed using injectable platelet-rich fibrin combined with Vitamin C (intervention group) and injectable platelet-rich fibrin alone (control group). Periapical healing was assessed using CBCT and periapical radiographs over 12 months. Postoperative pain and clinical normalcy were also evaluated.

Results: Both groups showed significant lesion reduction at 12 months (P = 0.001), with no significant between-group differences in postoperative lesion size (P = 0.981) or reduction magnitude (P = 0.497). CBCT-PAI scores improved in both groups without significant intergroup differences at baseline or follow-up. Two-dimensional radiographs showed a baseline difference (P = 0.007) but no postoperative differences; both groups demonstrated significant longitudinal reduction (P < 0.001). Postoperative pain scores were comparable between groups at all time points (P > 0.05), with a significant temporal decrease observed only in the intervention group (P = 0.001). All teeth remained asymptomatic during follow-up.

Conclusions: Both i-PRF combined with vitamin C and i-PRF alone appear to be effective regenerative scaffolds, demonstrating comparable clinical and radiographic outcomes in regenerative endodontic procedures.

Clinical trial registration: The study was registered with ClinicalTrials.gov (ID: NCT05585359), registered on 14 October 2022. Available at https://clinicaltrials.gov/study/NCT05585359 .