Application of Three Types of Scaffolds in Pulp Regeneration for Permanent Mature Teeth with Periapical Lesions: A Randomized Controlled Trial

Application of Three Types of Scaffolds in Pulp Regeneration for Permanent Mature Teeth with Periapical Lesions

Objective

This study aimed to compare different scaffolds for pulp regeneration in mature teeth with apical lesions. We looked at native chitosan-based scaffolds versus enzymatically modified chitosan-based scaffolds using clinical and radiographic methods.

Methods

Participants aged 15-45 with necrotic single-rooted teeth and periapical lesions were included. They were randomly divided into three groups:

Group A: Blood Clot (BC) scaffold
Group B: Native Chitosan and Blood Clot (NCS+BC) scaffold
Group C: Enzymatically-Modified Chitosan and Blood Clot (EMCS+BC) scaffold

Treatment involved two appointments for canal preparation, antibiotic application, and sealing. After three weeks, the regenerative procedure was performed based on group assignments. Participants were monitored for one, three, six, and twelve months to assess healing and tooth sensitivity.

Results

Thirty teeth from twenty-four participants were included. Key findings include:

No significant differences in healing among the groups at one, three, and twelve months.
After six months, the EMCS+BC group showed better healing compared to the other groups.
Tooth sensitivity was lower in the BC group than in the NCS+BC and EMCS+BC groups after six and twelve months.

Conclusion

The EMCS+BC scaffold showed better pulp regeneration after six months, while tooth sensitivity was higher in the NCS+BC and EMCS+BC groups. Overall, no significant differences were found at one, three, and twelve months.

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