Peri-Radicular Healing Following Endodontic Microsurgery Grafted with Leukocyte and Platelet Rich Fibrin (L-PRF): One Year Evaluation with Cone Beam Computed Tomography
Introduction: This observational retrospective study evaluated periradicular healing following endodontic microsurgery grafted with leukocyte and platelet-rich fibrin (L-PRF) using 2D periapical radiographs and 3D cone-beam computed tomography (CBCT). Methods: Seventy patients (77 surgical sites) were enrolled, of whom 51 cases met the inclusion criteria for analysis and comparison with a historical clinical standard group. Healing outcomes were assessed at one year using Molven’s 2D and PENN 3D criteria. Results: Complete cortical plate regeneration (C-score = 2) occurred in 58.1% of L-PRF cases versus 50% in the clinical standard group, although the differences were not statistically significant (OR 1.38; 95% CI: 0.49–4.00). The complete healing rates on 2D radiographs were 61.3% for L-PRF and 80.7% for the clinical standard; on CBCT, complete healing was 58.1% for L-PRF and 46.2% for the clinical standard, with no significant differences between groups. Adequate root-end filling significantly increased the odds of 2D complete healing (OR 6.91; p=0.0136). The overall success rates, including clinical symptoms, were 68.6% (2D) and 80% (3D) for L-PRF, comparable to controls. A pre-operative cortical plate thickness >0.5 mm was associated with improved cortical regeneration. Conclusion: The findings suggest that L-PRF may modestly enhance cortical bone healing after endodontic microsurgery, but the difference was not statistically significant. Given the autologous nature and biological properties of L-PRF, further randomized controlled trials with larger sample sizes and longer follow-up periods are warranted to clarify its clinical benefits, especially in complex lesions.
Networked Digital Library of Theses and Dissertations