Comparative Evaluation of Autologous Platelet Aggregates Versus Blood Clot On The Outcome Of Regenerative Endodontic Therapy: A Systematic Review and Meta-Analysis.

BACKGROUND

Regenerative endodontics represents a transformative approach to dental care, revitalizing necrotic teeth. This systematic review and meta-analysis evaluated the role of autologous platelet aggregates compared to the traditional blood clot method in regenerative endodontics.

MATERIAL AND METHODS

A systematic search was conducted in PubMed, Scopus, EBSCO, Open Grey, and Google Scholar between 1st-12th August 2024. Case series, RCTs, retrospective studies, and case reports were included. Meta-analysis on RCTs and case series utilized RevMan 5.4 software, with =0.05 as the significance level. The JBI risk of bias tool and GRADE system assessed study quality.

RESULTS

Nineteen studies met inclusion criteria, of which 13 were evaluated for risk of bias-11 showed low risk, and 2 were moderate. Rates of complete apical closure using PRF, BC, PRP, and CGF scaffolds ranged from 61.76% to 100%. Statistical analysis revealed no significant differences between autologous platelet aggregates and BC for outcomes such as complete apical closure (BC vs. PRP: =0.28; BC vs. PRF: =0.36), positive vitality (BC vs. PRP: =0.70; BC vs. PRF: =0.36), healing response (BC vs. PRF: =0.23), and overall success score (BC vs. PRP: =0.62).

CONCLUSIONS

BC remains an effective primary scaffold for non-vital teeth with open apexes. PRP and PRF are viable alternatives when intracanal blood induction is challenging. Overall, platelet aggregates and BC showed comparable clinical and radiographic outcomes. Apexogenesis, Autologous Platelet Aggregates, Blood Clot, Immature Tooth, Regenerative Endodontics.