While autologous platelet concentrates (APCs) have gained traction as promising regenerative materials in recent years, their impact on wound healing and tissue regeneration in periapical hard tissue defects remains controversial. Endodontic microsurgery (EMS) has embraced the potential of platelet concentrates, particularly L‐PRF (Leucocyte‐Platelet‐Rich Fibrin) and PRP (Platelet‐Rich Plasma), as regenerative tools. These concentrates, rich in growth factors and other bioactive molecules, are thought to enhance healing and treatment outcomes for various endodontic conditions. However, their effectiveness remains a subject of investigation. Despite encouraging 3‐D cone beam computed tomography (CBCT) based evidence for PRP's effectiveness in complex lesions and apico‐marginal defects, inconsistencies in its performance across preparation and application protocols raise questions about its superiority over existing options. More research is crucial to understand its full potential as a reliable regenerative tool in endodontics. L‐PRF and its derivatives are particularly effective in treating apical‐marginal defects. It enhances clinical attachment levels and reduces probing pocket depths, likely due to its slow and coordinated release of various growth factors. L‐PRF has been shown to also improve patients' quality of life by reducing postoperative swelling and pain. However, more research is needed to standardize its preparation methods and confirm its long‐term benefits. This paper aims to provide a comprehensive review of the current knowledge and recent advances in endodontic surgery and the use of platelet concentrates, focusing on their roles in managing periapical lesions and endo‐perio lesions.

中文翻译：

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牙髓手术和浓缩血小板：综合回顾


尽管自体血小板浓缩物（APC）近年来作为有前途的再生材料而受到关注，但它们对根尖周硬组织缺损的伤口愈合和组织再生的影响仍然存在争议。牙髓显微外科 (EMS) 充分利用了浓缩血小板作为再生工具的潜力，特别是 L-PRF（富含白细胞-血小板的纤维蛋白）和 PRP（富含血小板的血浆）。这些浓缩物富含生长因子和其他生物活性分子，被认为可以增强各种牙髓病的愈合和治疗效果。然而，它们的有效性仍然是一个研究课题。尽管基于 3D 锥形束计算机断层扫描 (CBCT) 的证据表明 PRP 在复杂病变和根尖边缘缺损中的有效性，但其在制备和应用方案中表现的不一致引发了人们对其相对于现有方案的优越性的质疑。更多的研究对于了解其作为牙髓学可靠再生工具的全部潜力至关重要。 L-PRF 及其衍生物在治疗根尖边缘缺损方面特别有效。它提高了临床附着水平并减少了探查袋深度，这可能是由于其缓慢且协调地释放各种生长因子。 L-PRF 已被证明还可以通过减少术后肿胀和疼痛来改善患者的生活质量。然而，需要更多的研究来标准化其制备方法并确认其长期效益。本文旨在对牙髓手术和血小板浓缩物的使用的当前知识和最新进展进行全面回顾，重点关注它们在治疗根尖周病变和牙周病变中的作用。