Application of titanium-platelet-rich fibrin (T-PRF) in the surgical management of a periapical lesion: A report of two cases

The primary goal of endodontic therapy is to eliminate infection and promote regeneration of periapical tissues. In cases of persistent pathology, periapical surgery combined with regenerative adjuncts may enhance healing. Titanium-prepared platelet-rich fibrin (T-PRF) provides a dense fibrin scaffold, sustained release of growth factors, and improved mechanical stability compared to conventional platelet-rich fibrin. Two young patients with trauma-induced periapical lesions in the maxillary anterior teeth underwent periapical surgery with root-end resection, retrograde mineral trioxide aggregate filling, and placement of autologous T-PRF membranes in the osseous defect. Both patients demonstrated uneventful healing, early resolution of symptoms, and progressive radiographic bone fill at 3, 6, and 12 months postoperatively. T-PRF appears to be a predictable and cost-effective adjunct to periapical surgery, promoting both soft tissue and bone regeneration.