The use of platelet-rich fibrin in maintaining vascularity for intentionally replanted teeth

Background

A primary goal for a mature tooth autotransplant is preserving tooth vitality. Platelet-rich fibrin (PRF) has characteristics that may improve the success of autotransplanted mature teeth by decreasing harmful inflammation and boosting vascular growth. This prospective human trial aimed to evaluate the effectiveness of PRF on vitality in a mature tooth replantation model.

Methods

This double-blind, randomized controlled trial included 18 participants with 70 single-rooted vital teeth planned for prosthetic extraction. Experimental teeth were extracted and apicoectomized to increase vascular growth. PRF was condensed into the canals before teeth were replanted in their respective sockets. In the same patient, control teeth received identical treatment without PRF. Teeth were splinted and monitored for 3 through 11 months before final vitality testing, extraction, and histologic analysis of pulpal tissue.

Results

Comparison of vitality testing did not yield statistically significant differences between experimental and control teeth. In addition, histologic evaluation of infiltrate type and health of pulp did not reveal any benefit from the addition of PRF. Out-of-mouth time marginally differed between experimental and control groups (mean difference, 0.26 [95% CI, −0.50 to −0.020]; P = .04) but did not affect vitality testing (P = .86). Inflammation state of the recipient site is believed to have confounded final results.

Conclusions

PRF applied to the periapical region did not improve the chances of vitality retention after extraction and replantation; however, it is possible site inflammation may have affected vitality results and confounded the effects of PRF.