Abstract

This case report describes the treatment of an immature permanent tooth (open apex) with periapical lesion which was treated with MTA apexification and platelet rich fibrin (PRF) as an internal matrix. The root canal of immature permanent tooth was prepared and was disinfected with 2.5% Saline, NaOCl and EDTA. Triple antibiotic paste comprising Ciprofloxacin, Metronidazole and Tetracycline was given for intra radicular disinfection. When the tooth became asymptomatic, PRF was prepared and placed in the apical end of tooth followed by Mineral Trioxide Aggregate (MTA) as a sealing agent. It was obturated with thermoplasticized gutta percha and restored with Polycarbonate crown after 15 days. Progressive healing and reappearance of normal trabaculae pattern in periapical area was seen in 3 months follow up. Our findings suggest that PRF can be used for accelerating the healing process and for providing a barrier for the sealing agent like MTA in immature permanent teeth with periapical lesion.

Keywords: Immature permanent teeth; Mineral trioxide aggregate; Platelet rich fibrin; Triple antibiotic paste