Title:Clinical, Radiographic, and Histologic Outcomes of Regenerative Endodontic
Treatment in Human Immature Teeth Using Different Biological
Scaffolds: A Systematic Review and Meta-analysis
Volume: 19
Issue: 4
Author(s): Mohammadreza Vatankhah, Shaghayegh Najary and Omid Dianat*
Affiliation:
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
Keywords:
Regenerative endodontics, tissue scaffolds, platelet-rich plasma, platelet-rich fibrin, blood clot, platelet pellet.
Abstract:
Background: Biological scaffolds such as blood clot (BC), platelet-rich plasma (PRP), platelet-
rich fibrin (PRF), and platelet pellet (PP) are used in regenerative endodontic treatments (RETs).
Objective: To systematically and quantitatively evaluate clinical, radiographic, and histologic outcomes
of RET studies using different biological scaffolds.
Methods: MEDLINE, Scopus, Cochrane library, and Embase were searched to identify studies on RET
procedures with any scaffold type performed on immature non-vital human teeth, employing any type of
biological scaffold. Clinical, radiographic, and histologic outcomes were extracted. Cochrane collaboration
risk of bias tool and Newcastle–Ottawa scale were used for quality assessment. Random and fixed
model meta-analysis was carried out with 95% confidence interval.
Results: Thirty-two studies were included in the qualitative analysis from the primarily retrieved 1895
studies. Only one study had high risk of bias and 71.8% of the studies had high quality. None of the studies
reported any histologic findings. Thirty studies were included in meta-analysis. Clinical success rate of
RET using either BC, PRP, or PRF was >99%. Furthermore, 32%, 23%, and 27% of BC, PRP, and PRF
cases regained vitality, respectively. Periapical healing was seen in 67%, 75%, and 100% of BC, PRP,
and PRF cases, respectively. There was no statistical difference between BC, PRP, or PRF regarding clinical
success or any radiographic outcomes.
Conclusion: There was no significant difference between BC, PRP, and PRF in terms of clinical and
radiographic outcomes. When it is difficult or dangerous to induce bleeding in root canals, PRP and PRF
may be employed instead.