Clinical Trial: Revitalization of Teeth With Necrotic Pulps and Open Apexes Using Platelet-Rich Plasma

Study Status: Terminated
Recruit Status: Terminated
Study Type: Observational

Official Title: Revitalization of Teeth With Necrotic Pulps and Open Apexes Using Platelet-Rich Plasma

Brief Summary: When root canals of infected teeth with closed ends are cleaned, disinfected and filled, the results are predictable with excellent outcomes. However, in a tooth with incomplete root development, the end of the root(s) must be closed before filling the root canals. One or two-step artificial barrier using mineral trioxide aggregate (MTA) has been used before filling the root canals of these teeth. Despite the high success of this treatment, this procedure does not result in complete root formation and these teeth are susceptible to root fracture. A number of case reports in scientific journal have shown the possibility for regeneration of nerve within the root canal space and continued root development in teeth with dead nerves and open ends. There is very little information regarding the use of stem cells and growth factors from the blood of patients to regenerate the nerves in these teeth. Platelet rich plasma (PRP) from whole blood has been mentioned in the literature as a potential ideal material for regeneration of nerves in these teeth. The purpose of this study is to investigate the use of PRP to regenerate tooth nerve and close the root ends in teeth with root canal infection and open root ends.

Detailed Summary:

Procedures Participants in this study must be in overall good health and not allergic to the materials used during this study treatment. If you agree to participate in this study, you will receive a screening visit to determine whether you will qualify for the study. At that time, your medical history will be reviewed, your blood pressure and pulse will be taken and you will be asked to fill out detailed medical and dental histories. In addition, you will receive an examination of your teeth and gums.

In the first appointment, after anesthetizing you with a local anesthetic similar to Novocain and application of a rubber dam to isolate your tooth, an opening will be made into the root canal(s). The canal(s) will be cleaned and medicated with antibiotics to get rid of the infection and sealed with a temporary filling material. Except for the use of antibiotics the rest of the procedures done in this appointment are similar to what the investigators do for the patients for need root canal treatment.

In the second appointment, after providing anesthesia with Novocain and application of rubber dam again, the temporary filling will be removed and the antibiotic will be removed using sterile water. The canal will be then dried. During this appointment, 20 ml of whole blood will be taken from your arm vein and will be used to prepare concentrated cells for injection into the prepared canal and sealed again with a temporary filling material. This part is different than what the investigators normally do for patients who need root canal treatment. For those patients the investigators fill the canals and seal the opening into the root canals with a permanent filling material.

You will return three to seven days later to the endodontic clinic and at that time, after rubber dam applica
Sponsor: Torabinejad, Mahmoud

Current Primary Outcome: stop the infection [ Time Frame: 6 weeks ]

Original Primary Outcome: Same as current

Current Secondary Outcome: Revitalizing the nerve of the tooth [ Time Frame: Every 3-6 months for two years ]

Original Secondary Outcome: Same as current

Information By: Loma Linda University

Dates:
Date Received: September 29, 2010
Date Started: October 2012
Date Completion:
Last Updated: April 3, 2014
Last Verified: April 2014