Clinical and Radiographic Outcomes of Autologous Platelet-Rich Products in Regenerative Endodontics: A Systematic Review and Meta-Analysis
<b>Background:</b> Regenerative endodontic therapy (RET) allows for continued root development in necrotic immature permanent teeth. Autologous platelet concentrates (APC) such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are proposed alternatives to conventional blood cl...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-05-01
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| Series: | Dentistry Journal |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2304-6767/13/6/236 |
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| Summary: | <b>Background:</b> Regenerative endodontic therapy (RET) allows for continued root development in necrotic immature permanent teeth. Autologous platelet concentrates (APC) such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are proposed alternatives to conventional blood clot scaffolds (BCS). <b>Objectives:</b> This systematic review compared the use of APC and BCS in RET of human necrotic immature permanent teeth. <b>Methods:</b> The electronic databases MEDLINE, CENTRAL and EMBASE were searched for randomized controlled trials (RCTs) which investigated the efficacy of APC and BCS in RET. We conducted this review following PRISMA 2020 guidelines. Quantitative radiographic outcomes of root length and root thickness were considered. The included RCTs were assessed for risk of bias using the Cochrane Risk-of-Bias tool. A meta-analysis was performed using RevMan 5.4. The protocol was registered on PROSPERO (CRD42023391536). <b>Results:</b> Of the 89 records screened, 10 RCTs were included in this review, in which 373 necrotic immature permanent teeth were treated. Both APC and BCS enable continued root development and would therefore be preferred over conventional root canal therapy with or without apexification. The meta-analysis revealed a statistically significant improvement in clinical success for PRP compared to BCS (Risk Ratio [RR] = 1.14, 95% Confidence Interval [CI]: 1.03–1.27, <i>p</i> = 0.02), whereas no significant difference was observed between PRP and PRF (RR = 1.04, 95% CI: 0.95–1.13, <i>p</i> = 0.37). <b>Conclusions:</b> PRP and PRF scaffolds enhance root length and thickness development in REPs compared to BCS. While PRP provides a modest but significant improvement in clinical success over BCS, PRF and PRP exhibit similar clinical outcomes. These findings support the use of platelet concentrates as viable alternatives to conventional blood clot scaffolds in regenerative endodontics. |
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| ISSN: | 2304-6767 |