Scaffolds for pulp revitalisation: A systematic review of randomized clinical trials

Abstract

AIMS: The main objective of this systematic review is to carry out a qualitative synthesis of the available bibliography on the use of scaffolds used in dentistry for the revitalisation treatment of immature teeth with open apex. MATERIAL AND METHODS: The search was carried out in the MEDLINE, Scopus and Cochrane databases. The search included the terms 'Pulp regeneration' OR 'Pulp revitalisation' AND 'scaffold'. The inclusion criteria were articles published in English, which carry out revitalisation treatments, with analysis of the results obtained and comparison of them, carried out in humans, in immature permanent teeth with open apex, and randomised clinical trials. The risk of bias assessment was performed with the RoB2 guideline. RESULTS: Of 769 studies, 10 met the inclusion criteria. The scaffolds used were blood clot, platelet-rich plasma, platelet-rich fibrin, and blood clots combined with different membranes such as collagen membrane, collagen membrane and placentrex, chitosan membrane and hydrogel with basic growth factor for fibroblasts. The clinical success rate is excellent for all scaffolds used. The best scaffold for root development is platelet-rich plasma and it is the scaffold with the highest percentage of response to vitality test. CONCLUSION: Our results suggested that platelet-rich plasma is the preferred scaffold of choice, although all the scaffolds analysed have acceptable results.