[24] In the present case, pulp of all four mandibular permanent i

[24] In the present case, pulp of all four mandibular permanent incisors continued to remain vital, and therefore, no endodontic treatment or extraction selleck kinase inhibitor was done. Traumatic bone cysts may undergo spontaneous resolution. Failure to treat may lead to pathological bone fracture. The treatment of choice for traumatic bone cysts is surgery for curettage of the bone walls, which generally results in short-term healing[17,23,25] and recurrence is rare. Enucleation of lesion was the treatment of choice.[26] It was a one-stage surgical treatment followed by placement of PRP inside the bony cavity. On surgical intervention, the bony cavity appeared to be empty. It has been noted that such content in the bone cavity may represent different stages in the development of traumatic bone cysts.

[27] The cavity may contain either a small amount of straw-colored fluid, shreds of necrotic blood clot, fragments of fibrous connective tissue.[10] Suei et al. evaluated whether gas was present in the cavity of simple bone cysts. Results showed the absence of water/air levels in these cysts on CT examination. This indicated that the operative finding of air in the cavity of simple bone cysts may have been in error at least in some cases.[28] Presumptive diagnosis of a traumatic bone cyst was made at the time of surgery; since the thin connective tissue membrane was scanty for histology. PRP works via the degranulation of the alpha granules in platelets, which contain growth factors. The active secretion of these factors is initiated by the clotting process of blood when PRP is activated by thrombin.

The secreted growth factors immediately bind to their transmembrane receptors on adult mesenchymal stem cells, osteoblasts, fibroblasts, epithelial cells and then cause cellular proliferation, matrix formation, osteoid production, and collagen synthesis through cellular message transforming.[29,30,31] PRP also contain three proteins in blood known to act as cell adhesion molecules for osteoconduction and as a matrix for bone and connective tissue. These molecules are fibrinogen, fibronectin, and vitronectin.[32] PRP placed along with bone graft bone appeared to enhance bone regeneration after cyst enucleation in pediatric patients.[33] Interestingly, in the present case, placement of PRP gel alone resulted in considerable filling of defectwith bone within a short period.

On coagulation, the PRP preparation assumes a sticky consistency due to its high fibrin content.[34] This ��sticky gel�� of PRP acts as a haemostatic agent, and stabilizes the blood clot. PRP also acts as an anti-inflammatory agent.[35] The use of PRP increases the vascularity in the first 20 days, with an increase of osteoblast and immature osteoid Drug_discovery tissue formation within 3-6 weeks, improving the quality and quantity of newly formed bone tissue.

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