Applications of Fibrin-based products in Endodontics: A Literature Review

Abstract

Introduction: Endodontic treatment of necrotic immature teeth is quite challenging. Current concepts for revitalization of these teeth known as regenerative endodontic treatment (RET) is based on key elements necessary for tissue engineering including stem cells, three-dimensional (3D) scaffolds, and growth factors. Utilizing an applicable scaffold for narrow root canal space with adequate properties is essential for successful outcome. Fibrin-based products are materials with various advantages as a scaffold. This review article aims to discuss the properties of different types of fibrin-based products and debates whether they are appropriate scaffolds for RET or not? Methods: An electronic search was performed using databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus. Keywords such as ('scaffold')AND ('fibrin gel' OR 'fibrin sealant' OR 'fibrin glue' OR 'fibrin tissue adhesive' OR 'fibrin hydrogel' OR 'platelet concentrate') AND ('tooth' OR 'teeth') AND/OR ('regenerative endodontics' OR 'dentistry') were used. Exclusion criteria included studies published in a language other than English and abstracts from congress. Results: Fibrin gel is a protein-based natural polymer hydrogel scaffold which can be easily used in the root canal. Platelet concentrates are autologous fibrin-based products used as scaffolds for RET with various favorable properties especially due to containing various growth factors. Conclusion: It seems that fibrin gel and platelet concentrates have adequate properties for use in RET; however, more evidence is required regarding the clinical outcome of applying these products as scaffolds for RET.