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Case Description: The main objective of this paper was to report the clinical effectiveness of leukocyte- platelet- rich fibrin (L-PRF) in the treatment of a combined endo-periodontal lesion of an upper first premolar.

Clinical Findings: The tooth had a profound abfraction on the vestibular aspect and presented no mobility but revealed a deep pocket measuring of 11 mm on the mesial vestibular aspect and 14 mm on the mesial palatine aspect. The three dimensional image analysis showed total bone loss in the mesial aspect and an extensively bone loss of the vestibular aspect of the vestibular root.

Treatment and Outcome: Endodontic treatment was performed and periodontal access surgery (surgical periodontal therapy) was done with the application of autologous L-PRF. Three month and 6 months after surgery, the cone beam computed tomography (CBCT) exams showed no bone regeneration in any aspect of the tooth. However, periodontal examination showed a significative improvement in the deepness of surcus. The mesial vestibular aspect had a deep pocket of 3 mm and 5 mm on the mesial palatine aspect showing a reduction in deepness of 8 mm and 9 mm, respectively.Clinical Relevance:  The actual treatment for teeth with bad prognosis is the extraction and replacement with implants. Even though implants are capable of restore function and aesthetic, the abuse of this approach have led to the loss of teeth that could be successfully treated with a less invasive technique. The prognosis of teeth with endoperiodontal lesion is poor but could be enhanced with regenerative therapies. Until now there are no clinical trials and just four case report about the treatment of these teeth with platelet rich fibrin.

Pablo Betancourt, Research Centre in Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile

Research Centre in Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile

Ricardo Elgueta, Facultad de Odontología, Universidad de La Frontera, Temuco, Chile

Facultad de Odontología, Universidad de La Frontera, Temuco, Chile

Ramon Fuentes, Research Centre in Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile

Research Centre in Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile
Betancourt, P., Elgueta, R., & Fuentes, R. (2024). Treatment of endo-periodontal lesion using leukocyte- platelet- rich fibrin. A case report. Colombia Medica, 48(4), 204–207. (Original work published December 22, 2017)

Rotstein I, Simon JH. Diagnosis, prognosis and decision-making in the treatment of combined periodontal-endodontic lesions. Periodontol 2000. 2004; 34: 165-203.

Sunitha VR, Emmadi P, Namasivayam A, Thyegarajan R, Rajaraman V. The periodontal - endodontic continuum: A review. J Conserv Dent. 2008; 11(2): 54-62.

Anand V, Govila V, Gulati M. Endo-Perio Lesion: Part II (The Treatment) - A Review. Archdent. 2012; 3(1): 10-16.

Goyal L. Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion. Restor Dent Endod. 2014; 39(1): 51-5.

Bielecki T, Dohan Ehrenfest DM, Everts PA, Wiczkowski A. The role of leukocytes from L-PRP/L-PRF in wound healing and immune defense: new perspectives. Curr Pharm Biotechnol. 2012;13(7): 1153-62.

Mosesson MW, Siebenlist KR, Meh DA. The structure and biological features of fibrinogen and fibrin. Ann N Y Acad Sci. 2001; 936: 11-30.

van Hinsbergh VW, Collen A, Koolwijk P. Role of fibrin matrix in angiogenesis. Ann N Y Acad Sci. 2001; 936: 426-37.

Sharma A, Pradeep AR. Treatment of 3-wall intrabony defects in patients with chronic periodontitis with autologous platelet-rich fibrin: a randomized controlled clinical trial. J Periodontol. 2011; 82(12): 1705-12.

Choukroun J, Adda F, Schoeffler C, Vervelle A. Une opportunité en paro-implantologie: Le PRF.Implantodontie. 2001; 42: 55-62.

Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009; 27(3): 158-67.

Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier JB. Three-Dimensional Architecture and Cell Composition of a Choukroun's Platelet-Rich Fibrin Clot and Membrane. J. Periodontol. 2010; 81(4): 546-55.

He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108(5): 707-13.

Li Q, Pan S, Dangaria SJ, Kolokythas A, Chu S, Geng Y, et al. Platelet-Rich Fibrin Promotes Periodontal Regeneration and Enhances Alveolar Bone Augmentation. Biomed Res Int. 2013; 2013: 638043. doi:10.1155/2013/638043.

Clipet F, Tricot S, Alno N, Massot M, Solhi H, Cathelineau G, Perez F, De Mello G, Pellen-Mussi P. In vitro effects of Choukroun's platelet-rich fibrin conditioned medium on 3 different cell lines implicated in dental implantology. Implant Dent. 2012; 21(1): 51-6.

El-Sharkawy H, Kantarci A, Deady J, Hasturk H, Liu H, Alshahat M, Van Dyke TE. Platelet-rich plasma: growth factors and pro- and anti-inflammatory properties. J Periodontol. 2007; 78(4): 661-669.

Moojen DJ, Everts PA, Schure RM, Overdevest EP, van Zundert A, Knape JT, Castelein RM, Creemers LB, Dhert WJ. Antimicrobial activity of platelet-leukocyte gel against Staphylococcus aureus. J Orthop Res. 2008; 26(3): 404-10.

Jia WT, Zhang CQ, Wang JQ, Feng Y, Ai ZS. The prophylactic effects of platelet-leucocyte gel in osteomyelitis: an experimental study in a rabbit model. J Bone Joint Surg Br. 2010; 92(2): 304-31

Karunakar P, Prasanna JS, Jayadev M, Shravani GS. Platelet-rich fibrin, a “faster healing aid” in the treatment of combined lesions: A report of two cases. J Indian Soc Periodontol. 2014; 18(5): 651-5.

Singh S. Management of an endo perio lesion in a maxillary canine using platelet-rich plasma concentrate and an alloplastic bone substitute. J Indian Soc Periodontol. 2009; 13(2): 97-100.

Nagaveni NB, Kumari KN, Poornima P, Reddy V. Management of an endo-perio lesion in an immature tooth using autologous platelet-rich fibrin: a case report. J Indian Soc Pedod Prev Dent. 2015; 33(1): 69-73.

Varughese V, Mahendra J, Thomas AR, Ambalavanan N. Resection and Regeneration - A Novel Approach in Treating a Perio-endo Lesion. J Clin Diagn Res. 2015; 9(3): ZD08-10..


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Received 2015-10-28
Accepted 2017-11-14
Published 2024-06-05