comparative evaluation of human amniotic membrane and platelet-rich fibrin (prf) for apexogenesis in immature non vital permanent teeth: a randomized controlled study

Pulp tissue in an immature open-apex tooth has a rich blood supply and contains stem cells that possess a great potential to regenerate in response to damage. Pulp necrosis of an immature tooth as a result of caries or trauma could arrest further development of the root, leaving the tooth with thin and weak walls that are prone to fracture. Endodontic treatment of such a tooth is difficult because thin walls do not allow much instrumentation, and the obturation might not provide predictable apical seal due to the large opening of the apex.

Regenerative endodontics is a novel modality which involves physiological replacement of the damaged structures of tooth like dentin, root and cells of the pulp-dentin complex. These procedures have not only shown to resolve apical periodontitis but continued root development, thus increasing the thickness and strength of the previously thin and fracture-prone roots.

Biological membranes have emerged as a promising tool for regenerative endodontics. These membranes are made of biocompatible materials that can create a barrier or scaffold that supports tissue regeneration and growth. Recently researched tissue engineering materials like platelet-rich fibrin (PRF), platelet-rich plasma (PRP), collagen, give promising results in regenerative endodontics.One such biologically/naturally derived tissue is the Human amniotic membrane (HAM) which has been utilized in the medical field since 1900. The presence of collagen, elastin, laminin and fibronectin makes this membrane an excellent scaffold in tissue engineering. HAM is biologically active due to the presence of growth factors (GF) that aids cell migration and facilitates wound healing.HAM in endodontic procedures, such as pulp capping and periapical surgery, have shown encouraging results.

Considering the regenerative potential of HAM, this study has been designed with the aim to evaluate the efficacy of Amniotic membrane as scaffold for regenerative endodontics will be compared to PRF regarding percentage change in apical width and root length.

AIMS AND OBJECTIVES:

To assess the clinical and radiographic outcomes when using human Amniotic membrane for apexogenesis in immature nonvital permanent teeth.

To compare the efficacy of human Amniotic membrane as scaffold in apexogenesis of immature nonvital permanent teeth as compared to PRF

MATERIALS AND METHODS:

The present study will be conducted in the Department of Conservative Dentistry and Endodontics, Faculty of Dental Science, King George’s Medical University, Lucknow, in collaboration with Department of Paediatric and preventive Dentistry, Faculty of Dental Science, King George’s Medical University, Lucknow.

The study will be conducted only after getting clearance from the Institutional Ethical Committee and registration in CTRI.

Suitable subjects will be selected from the department of Conservative Dentistry & Endodontics and Paediatric & Preventive Dentistry and will be randomly divided into two groups namely Platelet-rich fibrin group and human Amniotic Membrane group. This study includes a structured approach to evaluate the clinical and radiographic outcomes of the treatment and compare with baseline parameters over a specified follow-up period. The trial aims to assess the efficacy and safety of the procedure and the use of the amniotic membrane as a scaffold material in dental regenerative therapy.

The data obtained will be statistically analyzed. Any changes deemed in the interest of the study will be done accordingly.