Effect of injectable platelet rich fibrin augmented with vitamin c compared to injectable platelet rich fibrin alone on healing of necrotic mature single rooted teeth with chronic periapical periodontitis following regenerative endodontic therapy (a randomized controlled trial).

OBJECTIVES

To assess the healing potential, postoperative pain and clinical normalcy associated with injectable platelet-rich fibrin combined with Vitamin C in regenerative endodontic procedure using cone-beam computed tomography and two-dimensional radiograph.

METHODS

Twenty-eight healthy patients with mature permanent single-rooted teeth diagnosed with pulp necrosis and chronic apical periodontitis were randomly allocated into two groups (n = 14). Regenerative endodontic treatment was performed using injectable platelet-rich fibrin combined with Vitamin C (intervention group) and injectable platelet-rich fibrin alone (control group). Periapical healing was assessed using CBCT and periapical radiographs over 12 months. Postoperative pain and clinical normalcy were also evaluated.

RESULTS

Both groups showed significant lesion reduction at 12 months (P = 0.001), with no significant between-group differences in postoperative lesion size (P = 0.981) or reduction magnitude (P = 0.497). CBCT-PAI scores improved in both groups without significant intergroup differences at baseline or follow-up. Two-dimensional radiographs showed a baseline difference (P = 0.007) but no postoperative differences; both groups demonstrated significant longitudinal reduction (P < 0.001). Postoperative pain scores were comparable between groups at all time points (P > 0.05), with a significant temporal decrease observed only in the intervention group (P = 0.001). All teeth remained asymptomatic during follow-up.

CONCLUSIONS

Both i-PRF combined with vitamin C and i-PRF alone appear to be effective regenerative scaffolds, demonstrating comparable clinical and radiographic outcomes in regenerative endodontic procedures.

CLINICAL TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov (ID: NCT05585359), registered on 14 October 2022. Available at https://clinicaltrials.gov/study/NCT05585359 .