Table 2.
Comprehensive overview of the demographic details and characteristics of the included studies.
| Author | Journal | Type of Study | No.of patients | Groups | Scaffold | Outcome |
|---|---|---|---|---|---|---|
| Ulusoy et al., 2019 (11) | Journal of Endodontics | RCT | 88 teeth in 77 participants | 4 | PRF, PRP, BC, PP | Clinical: Follow up every 3 months in the first year and then annually. 76 teeth (86%) showed positive response to sensitivity tests in all groups. Radiographically: follow-ups every 6 months in the first year and then annually. 73.9% (n=54) teeth showed complete apical closure. Out of these 54 teeth, 41 (75.9%) teeth had natural conical-shaped root apex and 13 (24.1%) teeth had blunt apex. 4.1% (n=3) teeth had ongoing apical closure. 21.9% (n=16) teeth showed no signs of root development. Radiographically: Rate of complete apical closure in the groups, PP (82.4%), BC (76.2%), PRF (70.6%), PRP (66.7%). On 27 months follow-up, all teeth showed similar results for RRA and RCA. |
| Elsheshtawy et al.,2020 (12) | International Endodontics Journal | RCT | 26 participants Mean age 12.66 ±4.47 | 2 | PRP, BC | Clinically: favorable clinical outcomes. Patients experienced reduced symptoms and improved pulp vitality, indicating successful regeneration of pulp tissue. High patient satisfaction was reported with the treatment. Radiological Outcomes: The study assessed the effects of PRP as a scaffold in regeneration/revitalization endodontics using 2-dimensional radiographs and cone beam computed tomography (CBCT). The radiological assessment revealed significant improvements in periapical healing, root lengthening, and canal wall thickening. The CBCT images displayed evidence of successful tissue regeneration and dentin formation, further supporting the efficacy of PRP in endodontic treatments. |
| Jadhav et al.,2012 (25) | Journal of Endodontics | Clinical Study | 20 participants Age: 15-28 | 2 | PRP, BC | Clinical outcomes: demonstrated all cases were asymptomatic with complete resolution of signs. Radiological outcomes: PRP (group 2) showed significant improvement in periapical healing, apical closure, and dentinal wall thickening compared to BC (group 1). However, root lengthening was comparable between both groups. |
| Meschi et al., 2021 (26) | Journal of Endodontics | Multicentre controlled clinical trial | 23 teeth (9 test 14 control) | 2 | REP+ LPRF test group & REP- LPRF control group | Clinical Outcomes: Three teeth in the test group experienced flare-ups within the first year post-REP. Most analyzed teeth survived up to three years post-REP, with apexification used in failed cases. Qualitative assessment showed 55.6% of test group teeth had no root development or apical closure. Radiological Outcomes: PR evaluation found 91.3% and 87% achieving complete periapical bone healing (PBH) qualitatively and quantitatively, respectively, with no baseline differences between groups. However, CBCT showed only 50% of assessed teeth had complete PBH. Three years post-REP, volumetric measurements favored the control group in root hard tissue volume (p=0.03), mean thickness (p=0.003), and apical area (p=0.05). No significant differences were found in root lengthening (p=0.72) or maximum thickness (p=0.4). The correlation between PR and CBCT variables was weak to very weak. |
| Rizk et al.,2019 (19) | International Journal of paediatric dentistry | RCT | 26 | 2 | PRP, BC | Clinical outcomes: PRP-treated teeth showed no response to sensibility tests after 12 months, while BC-treated teeth exhibited significantly higher crown discoloration compared to PRP. Radiological outcomes: PRP-treated teeth demonstrated a statistically significant increase in radiographic root length, width, and periapical bone density, along with a decrease in apical diameter compared to BC-treated teeth. |
| Alagl et al., 2017 (18) | Journal of medical research | RCT | 15 participants (30 teeth) | 2 | PRP, BC | Clinical outcomes: The study suggests that PRP demonstrates success as a scaffold for regenerative endodontic treatment. However, aside from significantly increased root length, PRP did not yield outcomes significantly different from those using blood clot as the scaffold. Radiological outcomes: PRP-treated teeth exhibited statistically significant increases in root length and width, periapical bone density, and reductions in apical diameter compared to those treated with BC. Additionally, all treated teeth did not respond to sensibility tests after 12 months, and BC showed significantly higher crown discoloration than the PRP group. |
| Bezgin et al.,2015 (17) | Journal of Endodontics | RCT | 20 participants 22 teeth | 2 | PRP, BC | Clinical outcomes: PRP as a scaffold demonstrated promising clinical outcomes, including symptom resolution and positive pulp responses. It showed successful treatment for immature teeth. Radiological outcomes: Radiographically, PRP resulted in root development, periapical healing, and increased root length compared to conventional treatments. |
| Shivshankar et al.,2017 (13) | Journal of clinical and diagnostic research | RCT | 60 participants | 3 | PRP, BC, PRF | Clinical outcomes: PRP, PRF, and induced bleeding demonstrated successful symptom resolution and positive pulp responses in teeth with necrotic pulp and open apex. Patients showed improvement in tooth vitality and reduced symptoms. Radiological outcomes: All three approaches (PRP, PRF, induced bleeding) resulted in comparable outcomes for root development and periapical healing. There were no significant differences observed in radiographic measures such as root lengthening or periapical bone healing among the groups. |
| Mittal et al.,2021 (14) | Indian Journal of Dental Research | RCT | 36 teeth | 4 | BC, PRF, collagen, hydroxyapatite | Clinical outcomes: Pulp sensibility testing showed non-significant results across all intervals for all treatment groups (PRF, collagen, hydroxyapatite, periapical bleeding). Positive responses to the cold test were observed in varying percentages over time, with PRF demonstrating the highest responses at 12 months (66.6%). However, none of the groups showed positive responses to heat and electric pulp testing. All groups exhibited good periapical healing at the end of 12 months. Radiological outcomes: Radiographically, all treatment groups (PRF, collagen, hydroxyapatite, periapical bleeding) showed good periapical healing at the end of 12 months. However, specific differences in root development or other radiographic measures were not reported in the provided information. |
| Ragab et al., 2019 (15) | The Journal of Clinical Pediatric Dentistry | RCT | 22 teeth | 2 | BC, PRF | Clinical outcomes indicated significant improvement in symptoms across both BC and PRF groups. However, there were no notable differences in positive pulp responses between the two groups. Radiological outcomes: Most cases in both groups demonstrated evidence of periapical healing, often accompanied by the formation of calcific bridges at the cervical and/or apical regions. These findings suggest comparable effectiveness between BC and PRF as scaffolds in regenerative endodontic procedures, with no significant differences observed in radiographic outcomes after 12 months. |
| Sharma et al., 2016 (24) | Saudi dental Journal | Clinical Study | 16 cases | 2 | BC, PRP,PRF, BC+Collagen, BC+PLGA | Clinically, patients were completely asymptomatic throughout the study period. Radiological outcomes: All cases showed improvement in terms of periapical healing, apical closure, root lengthening, and dentinal wall thickening. PRF and collagen gave better results than blood clot and PLGA in terms of periapical healing, apical closure, and dentinal wall thickening |
| Rizk et al.,2020 (20) | International Journal of paediatric dentistry | RCT | 24 teeth | 2 | BC, PRF | Clinical Outcomes: At the end of the follow-up period, all treated teeth were negative to the sensibility test. Blood clot displayed greater crown discoloration in comparison to PRF group. Radiological outcomes: Root length and width, increased periapical bone density, and a reduction in apical diameter when compared with BC |
| Narang et al., 2015 (23) | Contemporary clinical dentistry | Clinical Study | 20 participants | 4 | MTA, PRF, PRP, BC | Clinical evaluation considered relief from pain, absence of swelling, drainage and resolution of sinus. Radiographic evaluation included periapical healing, apical closure, root lengthening, and dentinal wall thickening. There was no apical closure, root lengthening, and dentinal wall thickening in Group 1 as compared to other groups which was kept as a control group. |
| Youssef et al., 2022 (21) | International Endodontic Journal | RCT | 10 | 2 | BC, PRF | Clinical Outcomes: There was a significant difference between the tooth sensibility readings at baseline, 6-month and 12-month follow-up time points. Radiological findings: There was a significant increase in periradicular healing in both groups at 6 and 12 months, compared to that at baseline, with no significant difference between the studied groups after 12 months |
| Hongbing et al., 2018 (27) | BMC oral health | Retrospective controlled cohort study | 10 | 2 | BC, PRF | PRF achieved comparable outcomes to BC in terms of Clinical outcomes: Clinical sign and symptom resolution. Radiological findings: Periapical lesion healing and root maturation in RET |
| Nagaveni et al., 2020 (29) | International Journal of paediatric dentistry | Case Report | 2 teeth | 2 | BC, PRF | Clinical outcome: Both teeth showed a negative response to percussion and palpation tests but a positive response to cold and electric pulp tests. Radiological findings the tooth treated with PRF exhibited comparatively faster root lengthening, complete closure of the root apex, more thickening of the root dentinal walls, and narrowing of root canal space compared to conventionally revascularized tooth. |
| Uppala et al., 2020 (16) | European Journal of Molecular & Clinical Medicine | RCT | 24 teeth | 3 | BC, PRF, Collagen | Clinical outcomes: Clinical findings revealed varied healing outcomes in different age groups, with PRF, blood clot, and collagen treatments. Root lengthening outcomes varied too. Apical closure showed different distributions. Radiological findings: no significant differences were found among groups in healing, root lengthening, apical closure, and dentinal wall thickening, highlighting comparable outcomes. |
| Yang et al., 2023 (28) | Australian Endodontic Journal | Retrospective study | 121 teeth | 2 | CGF, BC | Clinical outcomes: In a study of 121 teeth from 107 children, 53 were treated with CGF and 68 with BC. Overall success rate was 91.74% over 23.15 months. Success rates were similar between CGF (86.79%) and BC (95.59%) groups, but teeth with developmental anomalies had higher success (98.39%) than those with trauma (84.31%). Radiological findings: Both CGF and BC groups showed many teeth with a score 2, indicating improved root characteristics. Scores did not differ significantly between the CGF and BC groups. |
| Ramachandran et al., 2021 (22) | Journal of Conservative Dentistry | Preliminary study | 40 | 2 | PRP, BC | Clinical outcomes: None of the groups tested positive for vitality Radiological findings: PRP showed increased RRA, although it was statistically non-significant |
PP: Platelet pellet, BC: Blood Clot, PRF: Plasma rich fibrin, PRP: platelet-rich plasma, RRA: Radiographic root area, RCA: radiographic canal area, CBCT: cone beam computed tomography, LPRF: Leukocyte- and Platelet-rich fibrin, REP: Regenerative endodontic procedure, PBH: Periapical bone healing, PR: Periapical radiograph, PLGA: Poly(lactic-co-glycolic acid), MTA: Mineral trioxide aggregate, RET: Regenerative endodontic therapy, CGF: Concentrated growth factor.