Abstract
AIM: This systematic review aims to assess the effectiveness of regenerative approaches in promoting periapical healing and restoring pulp vitality.
BACKGROUND: Periapical lesions of endodontic origin (LIPOE) are a common clinical issue that can compromise the prognosis of the affected tooth. While conventional treatment focuses on infection control and periapical healing, regenerative endodontics has emerged as a promising alternative.
RESULTS: The review protocol followed preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and was registered on PROSPERO (ID: CRD420251046339). A comprehensive electronic and manual search was conducted in three databases-MEDLINE via PubMed, Web of Science, and Cochrane-using keywords such as "periapical lesion," "regenerative endodontics," "platelet-rich fibrin," and "endodontic periapical lesion," focusing exclusively on randomized controlled trials (RCTs). Out of 135 initially retrieved articles, 10 RCTs met the inclusion criteria. Treatment outcomes were assessed through radiographic and clinical evaluations. Revascularization was the most commonly applied technique. The studies demonstrated a significant reduction in periapical lesion size, improved pulp vitality responses, and progressive tissue healing. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, and all included studies were found to have a low risk of bias.
CONCLUSION: The selected studies highlight the effectiveness of regenerative endodontic techniques in the treatment of LIPOE. While the overall results are encouraging, complete pulp regeneration remains limited.
CLINICAL SIGNIFICANCE: This review provides evidence-based information on the effectiveness of regenerative endodontic procedures (REPs) for the treatment of periapical lesions. It underscores the potential of these techniques in promoting periapical healing and partial pulp tissue regeneration, making it a valuable resource for clinicians and researchers in the field of endodontics. How to cite this article: Kawthar BS, Fatma B, Hanen B, et al. Regenerative Endodontics in the Treatment of Periapical Lesions of Endodontic Origin: A Systematic Review of Randomized Controlled Trials. J Contemp Dent Pract 2025;26(6):623-631.