(PR128) Optimizing Endodontic Surgery: A Systematic Review of Guided Tissue Regeneration, Grafting and Platelet Concentrates vs. No Intervention

Background: Guided tissue regeneration (GTR), grafting materials, and platelet concentrates show promise in enhancing bone regeneration and improving healing in endodontic surgery, but their consistent effectiveness remains uncertain.

Objective: This systematic review evaluates randomized controlled trials (RCTs) and prospective clinical trials to assess the efficacy of bone grafts, membranes, or platelet concentrates in endodontic periapical surgery using an evidence-based approach.

Methods: Searches were conducted in MEDLINE (PubMed), Embase, Cochrane Library, and gray literature databases through March 2024. 2 reviewers independently selected studies and extracted data. Eligible RCTs and clinical trials were critically appraised for bias and quality, and a meta-analysis was performed to determine treatment effects.

Results: 12 studies were included. The pooled success rate for periapical surgery using any regenerative material was 2.48 (OR: 2.48, 95% CI: 1.42-4.34). Subgroup analyses based on regenerative material type were conducted, showing significant results only for concentrated growth factor with bone graft (OR: 15.01, 95% CI: 1.12-271.70). Other materials showed substantial effects but were not statistically significant.

Discussion: Concentrated growth factor with bone graft significantly improves bone regeneration success over 12 months compared to other materials. However, further research with larger sample sizes and longer follow-up is needed.