Treatment of an endodontic-periodontal lesion using peripheral blood mesenchymal stem cells (PBMSCs) and platelet-rich fibrin matrix (PRFM): A case report

Abstract

In the current report, we discuss the available treatment options and present a successfully treated periodontal-endodontic lesion using autogenous peripheral blood mesenchymal stem cells (PBMSCs) and platelet-rich fibrin matrix (PRFM). A patient presented with a complaint of food impaction and bad breath. Clinically, the lower right first molar was non-vital and had a deep periodontal pocket and attachment loss. Radiographically, the distal root had an angular bone loss extending to the apex. The endodontic condition was treated with chemomechanical debridement, calcium hydroxide dressing, and obturation. Later, we reflected a full-thickness mucoperiosteal flap and thoroughly debrided the granulation tissue. We filled the defect with a gel containing PBMSCs and PRFM, prepared from the patient’s peripheral blood, and sutured the flap. After nine months, we noticed significant osseous fill and 5 mm of gain in the clinical attachment level. The outcomes of the case show the periodontal regenerative potential of the novel combination.

Keywords: Endo-periodontal lesion, Peripheral blood stem cells, Platelet-rich fibrin, Regenerative endodontics