Verma Saumya, Gupta Alpa, Mrinalini Mrinalini, Abraham Dax, Soma Unnati
MDS PG IIIrd year. Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College and Hospital, Surajkund Badkhal Road, Sector- 43, Faridabad, Haryana, 121004.
Professor, MDS. Department of Conservative Dentistry and Endodontics, Manav Rachna Dental College and Hospital, Surajkund Badkhal Road, Sector- 43, Faridabad, Haryana, 121004.
J Clin Exp Dent. 2025 Apr 1;17(4):e447-e460. doi: 10.4317/jced.62508. eCollection 2025 Apr.
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.
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.
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).
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.
再生牙髓治疗是一种变革性的牙科治疗方法，可使坏死牙齿恢复活力。本系统评价和荟萃分析评估了自体血小板聚集体与传统血凝块方法在再生牙髓治疗中的作用。
于2024年8月1日至12日在PubMed、Scopus、EBSCO、Open Grey和谷歌学术进行系统检索。纳入病例系列、随机对照试验、回顾性研究和病例报告。对随机对照试验和病例系列进行荟萃分析时使用RevMan 5.4软件，显著性水平设定为α=0.05。采用JBI偏倚风险工具和GRADE系统评估研究质量。
19项研究符合纳入标准，其中13项研究进行了偏倚风险评估——11项显示低风险，2项为中度风险。使用富血小板纤维蛋白（PRF）、血凝块（BC）、富血小板血浆（PRP）和浓缩生长因子（CGF）支架实现根尖完全闭合的比例在61.76%至100%之间。统计分析显示，在根尖完全闭合（BC与PRP：P=0.28；BC与PRF：P=0.36）、阳性活力（BC与PRP：P=0.70；BC与PRF：P=0.36）、愈合反应（BC与PRF：P=0.23）和总体成功评分（BC与PRP：P=0.62）等结果方面，自体血小板聚集体与BC之间无显著差异。
对于根尖开放的无活力牙齿，血凝块仍然是一种有效的主要支架材料。当根管内血液诱导具有挑战性时，PRP和PRF是可行的替代方案。总体而言，血小板聚集体和血凝块显示出相当的临床和影像学结果。根尖诱导成形术、自体血小板聚集体、血凝块、未成熟牙齿、再生牙髓治疗
