The Influence of Different Therapeutic Modalities and Platelet Rich Plasma on Apexogenesis: a Preliminary Study in Monkeys

Background: Traumatic injuries of permanent teeth with incomplete root formation are frequent during childhood. Adequate therapy is important for the further destiny of teeth with damaged pulp.

Objectives: To evaluate the effect of pulpotomy and high pulpotomy on the pulp and on root development, and the effect of platelet rich plasma (PRP) with hydroxyapatite (HAP) as a carrier and hydroxyapatite alone on apexogenesis.

Material And Methods: The study included eight monkeys (Cercopithecus aethiops) in which high pulpotomies were performed on the mandibular lateral incisors and canines, and pulpotomies were performed on the mandibular central incisors and premolars. The materials used in the study were commercial HAP (Apatec®, Stomygen) and PRP (prepared at the Torlak Institute of Immunology and Virology, Belgrade, Serbia.). Histological and radiological evaluations were done six months after the treatment.

Results: Considering the differences between HAP+PRP treated teeth in the pulpotomy group and teeth in the high pulpotomy group, two times more root growth retardation was observed in the high pulpotomy group. In the high pulpotomy group, root growth retardation was less common in HAP+PRP treated teeth (42.9%) than in HAP treated teeth (50%). In the pulpotomy group, retardation of root development was also less common in HAP+PRP treated teeth (25%) compared to HAP treated teeth (50%). There were differences between the pulpotomy and high pulpotomy groups, but without statistical significance.

Conclusions: The application of endogenous growth factors in conjunction with the preservation of dental pulp vitality can result in a good outcome for pulp therapy of injured teeth, which means successfully completed apexogenesis.