In vitro fibrin clot as an apical matrix – A new approach in apexification

Endodontic treatment of permanent teeth with open apices has always been a challenge, since an apical barrier is lacking for an effective apical seal. Single visit apexification using mineral trioxide aggregate is the recent treatment modality. Various materials have been used as apical matrix to prevent the extrusion of MTA. The use of growth and bone morphogenic factors with an artificial scaffold has also been suggested but this concept besides being expensive is still under research. This paper focuses on a treatment option that involves fabricating a matrix of platelet rich plasma in vitro and then introducing it into the canal against which MTAcan be used as an apical plug.

The venous blood taken from the patient is mixed with a radiopaque dye and centrifuged. The condensed plasma is carried into the root canal under rubber dam and its position is analysed radiographically. Against this matrix, Mineral trioxide aggregate is packed and obturation done in the same visit.

Open apices should be carefully evaluated and great degree of difficulty is encountered during their obturation.

Appropriate apexification using an apical barrier may be helpful in treating the case.

Radiographic evaluation of the apical matrix can be done.