Restorative Dentistry & Endodontics

Evaluation of platelet concentrates in regenerative endodontics: a systematic review and meta-analysis: Anna Tsiolaki, Dimitrios Theocharis, Nikolaos Tsitsipas, Anastasia Fardi, Konstantinos Kodonas; Restor Dent Endod 2025;50(4):e38. Published online November 28, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e38

Abstract PDF Supplementary Material PubReader ePub: Objectives
The aim of this systematic review is to compare the effectiveness of advanced platelet concentrates as regenerative endodontic therapeutic alternatives to blood clot (BC) revascularization in immature permanent necrotic teeth.
Methods
Randomized controlled trials (RCTs) comparing regenerative endodontic therapies using platelet-rich plasma (PRP), platelet-rich fibrin (PRF), or platelet pellet (PP) with the BC revascularization approach in immature permanent necrotic teeth were systematically searched in PubMed, Scopus, Cochrane Library, and Web of Science until May 2025. Data was extracted and analyzed both qualitatively and quantitatively. Study quality was assessed using the Cochrane Risk of Bias tool. A meta-analysis was conducted using IBM SPSS software (version 29.0), with success rates expressed as risk ratios and 95% confidence intervals (CIs).
Results
The initial search yielded 4,917 studies. After removing duplicates and applying eligibility criteria, 15 RCTs were included. Meta-analysis indicated no significant difference in the risk ratio (RR), as the BC method has similar success rates with PRP (10 studies; RR = 1.01; 95% CI, 0.94–1.09; p = 0.76) and PRF (8 studies; RR = 0.98; 95% CI, 0.89–1.08; p = 0.65) at 12 months. The primary outcomes evaluated were based on clinical and radiographic success.
Conclusions
Current evidence suggests PRP, PRF, and BC are all effective in treating immature permanent necrotic teeth with similar success rates. However, further research is needed to assess long-term outcomes.

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Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report: Fernando Córdova-Malca, Hernán Coaguila-Llerena, Lucía Garré-Arnillas, Jorge Rayo-Iparraguirre, Gisele Faria; Restor Dent Endod 2022;47(4):e35. Published online September 3, 2022; DOI: https://doi.org/10.5395/rde.2022.47.e35

Although the success rates of microsurgery and micro-resurgery are very high, the influence of a recurrent perforation combined with radicular cyst remains unclear. A 21-year-old white female patient had a history of root perforation in a previously treated right maxillary lateral incisor. Analysis using cone-beam computed tomography (CBCT) revealed an extensive and well-defined periapical radiolucency, involving the buccal and palatal bone plate. The perforation was sealed with bioceramic material (Biodentine) in the pre-surgical phase. In the surgical phase, guided tissue regeneration (GTR) was performed by combining xenograft (lyophilized bovine bone) and autologous platelet-rich fibrin applied to the bone defect. The root-end preparation was done using an ultrasonic tip. The retrograde filling was performed using a bioceramic material (Biodentine). Histopathological analysis confirmed a radicular cyst. The patient returned to her referring practitioner to continue the restorative procedures. CBCT analysis after 1-year recall revealed another perforation in the same place as the first intervention, ultimately treated by micro-resurgery using the same protocol with GTR, and a bioceramic material (MTA Angelus). The 2-year recall showed healing and bone neoformation. In conclusion, endodontic micro-resurgery with GTR showed long-term favorable results when a radicular cyst and a recurrent perforation compromised the success.

Citations

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Outcome of endodontic micro-resurgery: A systematic review
Faisal Alnassar, Riyadh Alroomy, Qamar Hashem, Abdullah Alqedairi, Nabeel Almotairy
Saudi Endodontic Journal.2025; 15(2): 112. CrossRef
Platelet-Rich Plasma and Platelet-Rich Fibrin in Endodontics: A Scoping Review
Simão Rebimbas Guerreiro, Carlos Miguel Marto, Anabela Paula, Joana Rita de Azevedo Pereira, Eunice Carrilho, Manuel Marques-Ferreira, Siri Vicente Paulo
International Journal of Molecular Sciences.2025; 26(12): 5479. CrossRef
Non-surgical Approach to a Maxillary Cyst-Like Lesion: Orthograde Endodontic Treatment With Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) Decontamination of the Canal System
Beatrice Spaggiari, Paolo Vescovi, Silvia Pizzi, Roberta Iaria, Ilaria Giovannacci
Cureus.2025;[Epub] CrossRef
Persistent Periradicular Lesion Associated With Concurrent Root Fracture and Odontogenic Keratocyst: A Case Report
Mehdi Vatanpour, Fatemeh Rezaei
Clinical Case Reports.2025;[Epub] CrossRef
Management of Apico-marginal Defects With Endodontic Microsurgery and Guided Tissue Regeneration: A Report of Thirteen Cases
Abayomi O. Baruwa, Jorge N.R. Martins, Mariana D. Pires, Beatriz Pereira, Pedro May Cruz, António Ginjeira
Journal of Endodontics.2023; 49(9): 1207. CrossRef

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4 Web of Science
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Leukocyte platelet-rich fibrin in endodontic microsurgery: a report of 2 cases: Mariana Domingos Pires, Jorge N. R. Martins, Abayomi Omokeji Baruwa, Beatriz Pereira, António Ginjeira; Restor Dent Endod 2022;47(2):e17. Published online March 4, 2022; DOI: https://doi.org/10.5395/rde.2022.47.e17

Abstract PDF PubReader ePub

Endodontic microsurgery is a predictable treatment option when orthograde treatment or retreatment is unsuccessful or unfeasible. However, when there is a gross compromise of periapical bone, achievement of bone regeneration after the surgical procedure may be hampered. In such cases, the application of guided tissue regeneration principles, with adjunctive use of leukocyte platelet-rich fibrin to fill the bone defect as a bone substitute and as a membrane to cover the site, provides a cost-effective solution with the benefits of accelerated physiological healing and reduced post-surgical pain and discomfort. This case report presents 2 cases of endodontic microsurgery of the upper lateral incisors with loss of buccal cortical plate, where platelet-rich fibrin was successfully applied.

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Citations to this article as recorded by

Focuses and Trends of Research on Platelet-Rich Fibrin: A Bibliometric and Visual Analysis
Ying Zhao, Chen Dong, Liumeizi Fan, Ting Lei, Xin Ge, Zhou Yu, Sheng Hu
Indian Journal of Plastic Surgery.2024; 57(05): 356. CrossRef

1,719 View
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1 Web of Science
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