Assessment of the efficacy of platelet-rich plasma in treatment of immature permanent teeth in children: a systematic review and meta-analysis

Background: Platelet-rich plasma (PRP) has been proposed as an adjunct scaffold for regenerative endodontic treatment (RET) in immature permanent teeth. The aim of this study is to evaluate whether PRP improves (i) overall clinical efficacy, (ii) periapical regeneration, and (iii) root canal healing in children with immature permanent teeth compared with conventional blood-clot scaffolds. Methods: A systematic search of six electronic databases was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Clinical trials assessing PRP in RET of immature permanent teeth were included. Pooled effects were calculated as relative risks (RR) with 95% confidence intervals (Mantel-Haenszel model). Results: Seven clinical trials were included. PRP was associated with a lower risk of unfavorable overall outcomes (RR 0.76, 95% CI 0.62–0.93; I ² = 0%) and a lower risk of unfavorable periapical outcomes (RR 0.54, 95% CI 0.43–0.67; I ² = 0%). No significant effect was observed for root canal healing (RR 1.01, 95% CI 0.83–1.23; I ² = 0%). Conclusions: PRP may improve periapical outcomes in RET of immature permanent teeth in children, but it does not appear to affect root canal healing. Given clinical and methodological variability across studies, further well-designed trials with standardized protocols are warranted. The PROSPERO Registration: CRD42024563068.