Impact of Platelet rich plasma in the healing of through-and-through periapical lesions using 2-D and 3-D evaluation: A randomized controlled trial

Abstract INTRODUCTION The purpose of this randomized controlled trial was to evaluate the role of platelet rich plasma (PRP) in the healing of through-and-through periapical lesions using both 2-dimensional (2D) periapical radiograph and 3-dimensional (3D) cone beam computed tomography (CBCT). METHODS 34 patients after confirmation of through-and-through periapical lesion were enrolled and randomly assigned to either the control or PRP group. Periapical surgery was performed and grafting of the bone defect with PRP was done in the PRP group prior to suturing and follow up was scheduled at 12 months for clinical and radiographic analysis based on Molven’s criteria, modified PENN 3D criteria and RAC indices. The absolute area and volume of the lesions were measured preoperatively and at follow up using Corel draw X7(64-bit) and ITK Snap software respectively. RESULTS 32 patients were available at follow up. A success rate of 93.7% was observed for both the control and PRP group on 2D evaluation while the PRP group exhibited a significantly higher success rate (87.5%) than the control (50%) on 3D assessment. A significantly higher percentage reduction in the lesion volume was documented in the PRP (92.30±4.72) group than the control (83.04±12.82). RAC indices revealed a significantly higher scoring at resected plane and cortical plate parameter in the PRP group. Overall analysis documented the faster reestablishment of palatal cortical plate than buccal cortical plate in through-and-through lesions. CONCLUSIONS These results suggests that PRP improves the healing outcome in through-and-through lesions. CBCT provides better healing assessment after periapical surgery over periapical radiographs in such lesions.