Efficacy of platelet concentrates on vital pulp treatment of fully developed and immature permanent teeth: a systematic review and network meta-analysis of human clinical trials.

This systematic review and network meta-analysis compared the efficacy of platelet concentrates with traditional bioactive capping materials on vital pulp treatment (VPT) healing outcomes in permanent human teeth. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist and a registered protocol (CRD42024614771), a search was conducted across PubMed, Web of Science, Scopus, ClinicalTrials.gov, and the Cochrane Library for studies published until March 31, 2025. Controlled clinical trials evaluating VPT success rates using platelet concentrates versus bioceramics in permanent teeth, with at least 6 months' follow-up, were included. Data from the selected studies were analyzed using the MetaInsight tool to assess multiple comparisons, and the risk of bias was evaluated using the Cochrane RoB2 and ROBINS-I tools. Evidence quality was graded using the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE). The search identified 1097 studies, with ten meeting the inclusion criteria, encompassing 437 patients and three treatment modalities. At 6 months, success rates for mature teeth showed no statistically significant differences: LPC (RR = 1.00; 95% CI: 0.96-1.04) and PRF (RR = 1.04; 95% CI: 0.96-1.12). For immature teeth, PRF demonstrated no significant effect (RR = 0.99; 95% CI: 0.92-1.06). At 12 months, outcomes remained non-significant for mature teeth with LPC (RR = 1.02; 95% CI: 0.90-1.15) and PRF (RR = 1.10; 95% CI: 0.94-1.28), and for immature teeth treated with PRF (RR = 1.00; 95% CI: 0.94-1.06). These findings suggest that while platelet concentrates may offer comparable outcomes, bioceramics should be considered the preferred option based on probabilistic analysis.PROSPERO registration number: CRD42024614771.