SynthesisOdontology2026
Clinical outcomes of regenerative endodontic procedures compared with apexification in young immature necrotic teeth: a systematic review of randomized controlled trials.
Synthesis in Odontology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Management of Failed Apexification Associated with Internal Root Resorption and Apical Calcification: A 56-Month Case Report.Dentistry journal · 2026Article
- Rare adverse root development after regenerative endodontic procedures: two case reports and contributing factors analysis.Frontiers in oral health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Immature permanent teeth with necrotic pulps present significant therapeutic challenges due to thin dentinal walls, wide-open apices, and poor fracture resistance. Apexification has traditionally been used to induce apical closure, but it does not promote further root development. Regenerative endodontic procedures (REPs) aim to restore biologic vitality and continue root maturation. This systematic review synthesizes randomized controlled trial (RCT) evidence comparing clinical and radiographic outcomes of REPs and apexification in young patients. A comprehensive search of PubMed, Cochrane Library, and ScienceDirect (2000-2025), supplemented by manual searches, was conducted following PRISMA 2020 guidelines (PROSPERO: CRD420251232516). Only RCTs involving immature necrotic permanent teeth treated with REP or apexification were included. Primary outcomes were root lengthening, dentinal wall thickening, and apical closure; secondary outcomes included periapical healing, survival, and adverse effects. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Of 709 records screened, five RCTs (2014-2018) met inclusion criteria. Across all trials, REPs consistently produced greater root length increases, enhanced dentinal wall thickening, and superior or comparable apical closure relative to apexification. Stem cell-based REP achieved the most substantial maturation (mean root length gain ≈ 5 mm). Periapical healing and tooth survival were uniformly high (≈ 100%) in both treatment groups. Adverse events were minimal and primarily limited to crown discoloration in TAP-based REP protocols. Based on the available randomized evidence, REPs demonstrate advantages over apexification in promoting root lengthening, dentinal wall thickening, and apical closure, while achieving similarly high periapical healing and tooth survival rates. These findings suggest that REPs represent a biologically favorable treatment option for immature necrotic permanent teeth. However, the limited number of RCTs, heterogeneity of REP protocols, and relatively short follow-up durations warrant caution.
Indexed as
Identifiers
41591708What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.