Evaluation of clinical and radiological success of the platelet-rich fibrin, chitosan and blood clot as a scaffold in the regenerative endodontic treatment of molar teeth

Aim: This study aimed to evaluate the application and long-term results of 3 different scaffolds, blood clot, PRF and chitosan, in the regenerative endodontic treatment of necrotic immature molars. Material and method: The study included 28 mandibular molar teeth of 25 patients (13 girls, 12 boys) aged 6-14 years who applied to Inonu University Faculty of Dentistry, Department of Paediatric Dentistry. Teeth were randomly divided into 3 different scaffold groups (blood clot, PRF, chitosan). After the treatment all patients were clinically and radiographically evaluated at 3, 6, 12, 18 and 24 month intervals to monitor their progress and treatment outcomes Results: When the preoperative and at the end of the follow-up period radiographs were compared, the decrease in PAI values, increase in Cvek root growth score, root length and root thickness were found to be statistically significant (p<0.05). Apical closure was observed in all teeth. The development of calcification in the root canal was assessed and calcification developed in 8 of 28 teeth (28.5%). 5 of 28 teeth were admitted to our clinic with the complaint of pain. 4 of these teeth were performed root canal treated and 1 was extracted. Based on the increase in root length it was seen that the most effective scaffold is blood clot, the least effective scaffold is chitosan, and it was found that the difference between them is statistically significant (p<0.05). There was no statistically significant difference between the scaffolds in any of the other findings (p>0.05). Conclusion: Regenerative endodontic treatments offer successful results in necrotic immature molars. Chitosan is an alternative scaffold that can be used effectively and safely in regenerative endodontic treatments. Clinical studies with larger sample sizes are needed to compare the success of different scaffolds in regenerative endodontic treatment.