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Use of Platelet-Rich Plasma Combined With Hydroxyapatite in the Management of a Periodontal Endosseous Defect Associated With a Palato-Radicular Groove: A Case Report.

INTRODUCTION
Various root developmental anomalies, such as palato-radicular groove, have been associated with worsening the periodontal condition. Platelet-rich plasma (PRP), an autologous concentration of platelets, has been reported to significantly enhance bone and soft-tissue healing and the combination of PRP and a hydroxyapatite (HA) osseous graft has been demonstrated to be efficacious in the treatment of periodontal endosseous defects. Here, we present a 1-year follow-up report of such a clinical case, treated by the combined use of PRP and HA osseous graft for periodontal regeneration and, finally, restorative therapy.


CASE PRESENTATION
A 36-year-old Indian female reported with pain in the upper maxillary incisor region. On clinical and radiologic examination, a deep 3-wall periodontal endosseous defect was found mesial to the maxillary left lateral incisor that was etiologically associated with the presence of a palato-radicular groove, leading to the development of a periapical lesion. Endodontic therapy, non-surgical periodontal therapy, and surgical periodontal therapy with a mixture of PRP gel and HA were performed. One-year examination showed uneventful healing and complete elimination of the periodontal pocket.


CONCLUSIONS
A palato-radicular groove may serve as a pathway for the development of a periodontal endosseous defect and for pulpal involvement. The combination of PRP and HA may be efficacious in the treatment of such a periodontal endosseous defect. Additional research should be performed to evaluate the efficacy of PRP and HA in the treatment of periodontal endosseous defects.