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Year : 2015  |  Volume : 4  |  Issue : 3  |  Page : 150-154

Retreatment of endodontically failed tooth with wide-open apex using platelet rich fibrin membrane as matrix and an apical plug of Biodentine™

1 Department of Conservative Dentistry and Endodontics, Dr. D. Y. Patil Dental School, Lohegaon, Pune, Maharashtra, India
2 Department of Dentistry, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India
3 Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
4 Department of Conservative Dentistry and Endodontics, YMT Dental College and Hospital, Kharghar, Mumbai, Maharashtra, India

Correspondence Address:
Ajinkya Mansing Pawar
Y-10/155, Government Colony, Bandra East, Mumbai - 400 051, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2278-9626.163341

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The primary reason for an endodontic failure is the persistence or regrowth of bacteria within the root canal system, and such cases require retreatment. The tooth root development and closure of its apex occurs till 3 years after the eruption. Traumatic injuries during this development period result in endodontic complications. While dealing with a tooth, with an open apex the prime objective was eliminating bacteria from the root canal system with minimum irritation to the periapical tissues and induction of apical closure to produce favorable conditions and to confine the root canal filling within the canal space. Traditionally as supported by literature multiple dressings of calcium hydroxide medicament were advocated to induce apical barrier formation followed by an evolution of the apical artificial barrier technique where the mineral trioxide aggregate (MTA) was used. Recently introduced Biodentine is similar to MTA with its basic composition, which can be used as its substitute. The main difficulty associated while treating teeth with wide-open apices are preventing the overfilling of the restorative materials that serve as an artificial barrier. Use of a matrix overcomes this challenge. Platelet-rich fibrin (PRF) a matrix of autologous fibrin, embedded with a large quantity of platelet and leukocyte cytokines during centrifugation can be successfully used as an apical membrane. The present case, reports a novel procedure of apexification of endodontically failed central incisor with open apex using PRF as apical membrane and Biodentine™.

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