Optimizing Endodontic Surgery: A Systematic Review of Guided Tissue Regeneration, Grafting, and Platelet Concentrates vs. No Intervention
<b>Background/Objectives:</b> Guided tissue regeneration (GTR) and the use of various grafting materials and platelet concentrates have emerged as promising adjunctive techniques in endodontic surgery to enhance bone regeneration and improve healing outcomes, although evidence regarding...
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MDPI AG
2025-02-01
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| author | Mohammad Sabeti Natalie Black Mohsen Ramazani Nafiseh Zarenejaddivkolahei Mahmood Moosazadeh |
| author_facet | Mohammad Sabeti Natalie Black Mohsen Ramazani Nafiseh Zarenejaddivkolahei Mahmood Moosazadeh |
| author_sort | Mohammad Sabeti |
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| description | <b>Background/Objectives:</b> Guided tissue regeneration (GTR) and the use of various grafting materials and platelet concentrates have emerged as promising adjunctive techniques in endodontic surgery to enhance bone regeneration and improve healing outcomes, although evidence regarding their consistent effectiveness remains inconclusive. The aim of this systematic review is to evaluate existing randomized controlled trials (RCTs) and prospective clinical trials to determine the efficacy of bone grafts, membranes, or platelet concentrates on outcomes in endodontic periapical surgery, employing a robust evidence-based approach. <b>Methods</b>: Searches were conducted in MEDLINE (PubMed), Embase, Cochrane Library, and gray literature databases from their inception until March 2024. Study selection and data extraction were conducted independently by two reviewers. Eligible randomized controlled trials (RCTs) and prospective clinical trials underwent critical appraisal for risk of bias and quality of evidence and were subjected to meta-analysis to determine treatment effects. <b>Results</b>: Twelve studies were included. The pool success rate for periapical surgery using any regenerative material (bone graft, membrane, or platelet concentrate) was 2.48 (OR: 2.48, 95% CI: 1.42–4.34). Multiple subgroup analyses based on the type of regenerative material used during treatment were performed, presenting high certainty of evidence. The subgroup analysis, which examined bone graft only, bone graft with membrane, membrane only, concentrated growth factor only, and concentrated growth factor with bone graft, yielded significant results only for concentrated growth factor with bone graft (OR: 15.01, 95% CI: 1.12–271.70). While the success rate of periapical surgery with other regenerative materials did not reach statistical significance, the effect size was substantial. <b>Conclusions:</b> Overall, the findings indicate that utilizing a concentrated growth factor with a bone graft significantly improves the success of bone regeneration procedures over a 12-month follow-up period compared to interventions without these components. However, more research will be needed with larger sample sizes and longer follow-up times. |
| format | Article |
| id | doaj-art-805527c7067e43dd9cf3fa7bbb5aec08 |
| institution | Kabale University |
| issn | 2304-6767 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
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| series | Dentistry Journal |
| spelling | doaj-art-805527c7067e43dd9cf3fa7bbb5aec082025-08-20T03:43:33ZengMDPI AGDentistry Journal2304-67672025-02-011339110.3390/dj13030091Optimizing Endodontic Surgery: A Systematic Review of Guided Tissue Regeneration, Grafting, and Platelet Concentrates vs. No InterventionMohammad Sabeti0Natalie Black1Mohsen Ramazani2Nafiseh Zarenejaddivkolahei3Mahmood Moosazadeh4Advanced Specialty Program in Endodontics, UCSF School of Dentistry, 707 Parnassus Ave. Room-D 3226, San Francisco, CA 94143, USAUCSF Advanced Specialty Program in Endodontics, 707 Parnassus Ave. Room-D 3226, San Francisco, CA 94143, USAIranian Center for Endodontic Research & Medical Education Research and Development, Mazandaran University of Medica Sciences, Sari 48175-866, IranDepartment of Restorative Dentistry and Endodontics, Dental School, Mazandaran University of Medica Sciences, Sari 48175-866, IranNoncommunicable Disease Institute, Mazandaran University of Medical Science, Sari 48175-866, Iran<b>Background/Objectives:</b> Guided tissue regeneration (GTR) and the use of various grafting materials and platelet concentrates have emerged as promising adjunctive techniques in endodontic surgery to enhance bone regeneration and improve healing outcomes, although evidence regarding their consistent effectiveness remains inconclusive. The aim of this systematic review is to evaluate existing randomized controlled trials (RCTs) and prospective clinical trials to determine the efficacy of bone grafts, membranes, or platelet concentrates on outcomes in endodontic periapical surgery, employing a robust evidence-based approach. <b>Methods</b>: Searches were conducted in MEDLINE (PubMed), Embase, Cochrane Library, and gray literature databases from their inception until March 2024. Study selection and data extraction were conducted independently by two reviewers. Eligible randomized controlled trials (RCTs) and prospective clinical trials underwent critical appraisal for risk of bias and quality of evidence and were subjected to meta-analysis to determine treatment effects. <b>Results</b>: Twelve studies were included. The pool success rate for periapical surgery using any regenerative material (bone graft, membrane, or platelet concentrate) was 2.48 (OR: 2.48, 95% CI: 1.42–4.34). Multiple subgroup analyses based on the type of regenerative material used during treatment were performed, presenting high certainty of evidence. The subgroup analysis, which examined bone graft only, bone graft with membrane, membrane only, concentrated growth factor only, and concentrated growth factor with bone graft, yielded significant results only for concentrated growth factor with bone graft (OR: 15.01, 95% CI: 1.12–271.70). While the success rate of periapical surgery with other regenerative materials did not reach statistical significance, the effect size was substantial. <b>Conclusions:</b> Overall, the findings indicate that utilizing a concentrated growth factor with a bone graft significantly improves the success of bone regeneration procedures over a 12-month follow-up period compared to interventions without these components. However, more research will be needed with larger sample sizes and longer follow-up times.https://www.mdpi.com/2304-6767/13/3/91periapical surgeryapicoectomyendodontic surgerybone grafttissue regenerationplatelet concentrates |
| spellingShingle | Mohammad Sabeti Natalie Black Mohsen Ramazani Nafiseh Zarenejaddivkolahei Mahmood Moosazadeh Optimizing Endodontic Surgery: A Systematic Review of Guided Tissue Regeneration, Grafting, and Platelet Concentrates vs. No Intervention Dentistry Journal periapical surgery apicoectomy endodontic surgery bone graft tissue regeneration platelet concentrates |
| title | Optimizing Endodontic Surgery: A Systematic Review of Guided Tissue Regeneration, Grafting, and Platelet Concentrates vs. No Intervention |
| title_full | Optimizing Endodontic Surgery: A Systematic Review of Guided Tissue Regeneration, Grafting, and Platelet Concentrates vs. No Intervention |
| title_fullStr | Optimizing Endodontic Surgery: A Systematic Review of Guided Tissue Regeneration, Grafting, and Platelet Concentrates vs. No Intervention |
| title_full_unstemmed | Optimizing Endodontic Surgery: A Systematic Review of Guided Tissue Regeneration, Grafting, and Platelet Concentrates vs. No Intervention |
| title_short | Optimizing Endodontic Surgery: A Systematic Review of Guided Tissue Regeneration, Grafting, and Platelet Concentrates vs. No Intervention |
| title_sort | optimizing endodontic surgery a systematic review of guided tissue regeneration grafting and platelet concentrates vs no intervention |
| topic | periapical surgery apicoectomy endodontic surgery bone graft tissue regeneration platelet concentrates |
| url | https://www.mdpi.com/2304-6767/13/3/91 |
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