Abstract
Introduction
Regenerative endodontic procedures (REPs) are intended to repair and regenerate part
of the pulp-dentin complex. The aim of this study was to systematically appraise the
existing evidence on the effectiveness of REPs on mature teeth with pulp necrosis
and apical periodontitis.
Methods
Electronic database and hand searches were performed on 8 databases of published and
unpublished literature from inception to January 3, 2021, for the identification of
randomized controlled trials (RCTs) or prospective clinical trials. The related key
words included “regenerative,” “pulp revascularization,” “revitalization procedure,”
and “necrotic mature teeth.” A random effects meta-analysis was conducted assessing
success as the main outcome treatment. Risk of bias was assessed through the Cochrane
Risk of Bias 2.0 tool, and the quality of the evidence was assessed with the Grading
of Recommendations Assessment, Development and Evaluation approach.
Results
Of the 337 initial hits, 4 RCTs were eligible for inclusion, whereas 3 were included
in the quantitative synthesis. Overall, there was no difference in the relative risk
for a successful/unsuccessful treatment outcome between REPs or conventional treatment
(3 studies, relative risk = 1.03; 95% confidence interval, 0.92–1.15; P = .61; heterogeneity I2 = 0.0%, P = .53; prediction interval = 0.51–2.09). Risk of bias ranged from low to raising
some concerns, whereas the quality of the evidence was graded as moderate.
Conclusions
Based on moderate-quality evidence, REPs appear as a viable treatment alternative
for mature necrotic teeth with periapical lesions at present. Furthermore, well-designed
RCTs might also provide confirmatory evidence in this respect while also framing a
backbone for standardization of the therapeutic protocol of REPs.
Key Words
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Article info
Publication history
Published online: March 31, 2021
Identification
Copyright
© 2021 American Association of Endodontists.
