Effect of Intracanal Scaffolds on the Success Outcomes of Regenerative Endodontic Therapy - A Systematic Review and Network Meta-analysis

Rahul, Morankar; Lokade, Amolkumar; Tewari, Nitesh; Mathur, Vijay; Agarwal, D.; Goel, Shubhi; Keshari, Pankaj; Sharma, Sidhartha; Bansal, Kalpana

doi:10.1016/j.joen.2022.11.011

Cited by 11 publications

(13 citation statements)

References 63 publications

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“…This could be explained by the general finding that the increase in root length is usually observed after apparent increase in root thickness and often occurs 18-24 months after treatment. 47 Some previous randomized clinical trials (RCTs) showed no difference between PRF and PRP. [48][49][50] The decrease in canal diameter at 4 mm from the CEJ, though it occurred with a small degree in both groups, could be explained by the added effect of MTA placed cervically which allowed for the induction of new hard tissue formation and stimulated the release of bioactive dentin matrix components.…”

Section: Discussionmentioning

confidence: 99%

“…A small degree of increase in root length occurred in both groups. This could be explained by the general finding that the increase in root length is usually observed after apparent increase in root thickness and often occurs 18–24 months after treatment 47 . Some previous randomized clinical trials (RCTs) showed no difference between PRF and PRP 48–50 …”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the efficacy of injectable platelet‐rich fibrin versus platelet‐rich plasma in the regeneration of traumatized necrotic immature maxillary anterior teeth: A randomized clinical trial

Abo‐Heikal,

El‐Shafei,

Shouman

et al. 2023

Dental Traumatology

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Background/AimThis study aimed at comparing the regenerative potential of injectable platelet‐rich fibrin (i‐PRF) (Group 1) and platelet‐rich plasma (Group 2) scaffolds.Materials and methodsTwenty‐three patients, aged from 9 to 24 years, having 24 immature traumatized necrotic maxillary anterior teeth, were enrolled. Teeth trauma was confirmed by patients' history. Preoperative three‐dimensional scans were done. In the first visit, canals were irrigated with 1.5% sodium hypochlorite then medicated with calcium hydroxide. After 2 weeks, patients were randomly assigned into one of the treatment groups (n = 12). The platelet concentrate was applied after centrifuging 10 mL of autologous venous blood with respect to the centrifugation protocol for each platelet concentrate. Patients were recalled at 6 and 12 months posttreatment, during which clinical and radiographic examinations and assessment of pulp sensitivity were done. Three‐dimensional scanning was done after 12 months. The increase in root length and decrease in root canal diameters were calculated at three canal levels. Statistical analysis was done using the paired t‐test and the independent t‐test. The significance level was set at p < .05.ResultsThere was no statistically significant difference between both groups regarding the increase in root length, decrease in coronal and middle canal diameters and the response to the electric pulp tester. Group (1) showed significantly greater decrease in apical canal diameter than Group (2) (p = .008).ConclusionI‐PRF can be considered as a valid regenerative scaffold for clinical use and with regards to the easier preparation technique, it is more recommended than platelet‐rich plasma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of the efficacy of injectable platelet‐rich fibrin versus platelet‐rich plasma in the regeneration of traumatized necrotic immature maxillary anterior teeth: A randomized clinical trial

Abo‐Heikal,

El‐Shafei,

Shouman

et al. 2023

Dental Traumatology

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“…Among the current studies screened, there was only one network meta-analysis focused on the comparison of exogenous scaffolds and traditional BC methods in dental pulp regeneration, but it included many non-RCTs, which decreased the certainty of the evidence [ 44 ]. In contrast, this review included only RCT studies, excluding the possibility that cases using exogenous scaffolds were due to poorer tooth conditions or unsuccessful bleeding, thus ensuring the validity of the results and conclusions.…”

Section: Discussionmentioning

confidence: 99%

Does the use of different scaffolds have an impact on the therapeutic efficacy of regenerative endodontic procedures? A systematic evaluation and meta-analysis

Yang,

Sheng,

et al. 2024

BMC Oral Health

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Background In the regenerative endodontic procedures, scaffolds could influence the prognosis of affected teeth. Currently, there is controversy regarding the postoperative evaluation of various scaffolds for pulp regeneration. The objective of this study was to access whether other scaffolds, used alone or in combination with blood clot (BC), are more effective than BC in regenerative endodontic procedures. Methods We systematically search the PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Google Scholar databases. Randomized controlled trials examining the use of BC and other scaffold materials in the regenerative endodontic procedures were included. A random effects model was used for the meta-analysis. The GRADE method was used to determine the quality of the evidence. Results We screened 168 RCTs related to young permanent tooth pulp necrosis through electronic and manual retrieval. A total of 28 RCTs were related to regenerative endodontic procedures. Ultimately, 12 articles met the inclusion criteria and were included in the relevant meta-analysis. Only 2 studies were assessed to have a low risk of bias. High quality evidence indicated that there was no statistically significant difference in the success rate between the two groups (RR=0.99, 95% CI=0.96 to 1.03; 434 participants, 12 studies); low-quality evidence indicated that there was no statistically significant difference in the increase in root length or root canal wall thickness between the two groups. Medium quality evidence indicated that there was no statistically significant difference in pulp vitality testing between the two groups. Conclusions For clinical regenerative endodontic procedures, the most commonly used scaffolds include BC, PRP, and PRF. All the different scaffolds had fairly high clinical success rates, and the difference was not significant. For regenerative endodontic procedures involving young permanent teeth with pulp necrosis, clinical practitioners could choose a reasonable scaffold considering the conditions of the equipment and patients.

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“…Platelet-rich fibrin showed a more substantial regenerative potential of DPSCs, compared with platelet-rich plasma, mainly in LPS-induced inflammatory states, which has been confirmed by clinical trials of necrotic permanent teeth [ 105 , 106 , 107 , 108 ]. Studies have shown that placing autologous platelet-rich plasma or platelet-rich fibrin into the treated root canal could promote the continued development of the root apex of young permanent teeth, and it also promotes the restoration of pulp sensitivity to a certain extent when applied to mature permanent teeth with pulp necrosis [ 107 , 109 , 110 ].…”

Section: Strategiesmentioning

confidence: 99%

Creating a Microenvironment to Give Wings to Dental Pulp Regeneration—Bioactive Scaffolds

Jiang

et al. 2023

Pharmaceutics

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Dental pulp and periapical diseases make patients suffer from acute pain and economic loss. Although root canal therapies, as demonstrated through evidence-based medicine, can relieve symptoms and are commonly employed by dentists, it is still difficult to fully restore a dental pulp’s nutrition, sensory, and immune-regulation functions. In recent years, researchers have made significant progress in tissue engineering to regenerate dental pulp in a desired microenvironment. With breakthroughs in regenerative medicine and material science, bioactive scaffolds play a pivotal role in creating a suitable microenvironment for cell survival, proliferation, and differentiation, following dental restoration and regeneration. This article focuses on current challenges and novel perspectives about bioactive scaffolds in creating a microenvironment to promote dental pulp regeneration. We hope our readers will gain a deeper understanding and new inspiration of dental pulp regeneration through our summary.

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Effect of Intracanal Scaffolds on the Success Outcomes of Regenerative Endodontic Therapy - A Systematic Review and Network Meta-analysis

Cited by 11 publications

References 63 publications

Evaluation of the efficacy of injectable platelet‐rich fibrin versus platelet‐rich plasma in the regeneration of traumatized necrotic immature maxillary anterior teeth: A randomized clinical trial

Evaluation of the efficacy of injectable platelet‐rich fibrin versus platelet‐rich plasma in the regeneration of traumatized necrotic immature maxillary anterior teeth: A randomized clinical trial

Does the use of different scaffolds have an impact on the therapeutic efficacy of regenerative endodontic procedures? A systematic evaluation and meta-analysis

Creating a Microenvironment to Give Wings to Dental Pulp Regeneration—Bioactive Scaffolds

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