Regenerative Endodontic Procedures: Mapping and Critical Appraisal of Clinical Trial Evidence

Regenerative endodontic procedures (REPs) are biologically based approaches aimed at restoring the vitality of immature teeth with pulp necrosis. Over the past decades, these procedures have gained increasing attention. This study mapped and critically appraised the clinical trial evidence on REPs, providing an overview of research trends and methodological characteristics.

A comprehensive bibliometric analysis was conducted following Bibliometric Reviews of the Biomedical Literature guidelines using the Web of Science Core Collection database. Randomized and nonrandomized clinical trials available in the database up to 2025 were included, covering the full period of indexed clinical evidence on REPs. Quantitative variables (citations, countries, journals, and keywords) and qualitative aspects (techniques, materials, irrigants, intracanal medications, and barriers) were analyzed.

Among the 6,287 retrieved records, 58 clinical studies met the inclusion criteria. The most productive authors were De-Jesus-Soares A, Gomes BPFA, Kang J, Nazzal H, and Elheeny AAH. The most cited author was Xuan K, with 346 citations. Asia was the most productive continent, and the Journal of Endodontics published the highest number of studies. The most frequent keywords were regenerative endodontics, revascularization, and immature teeth. Blood clot induction was the predominant regenerative technique, while sodium hypochlorite, triple antibiotic paste, and mineral trioxide aggregate were the most commonly used irrigant, intracanal medication, and barrier material, respectively.

Clinical evidence on REPs suggests a consolidation of biologically based strategies, particularly blood clot induction with mineral trioxide aggregate barriers. However, methodological heterogeneity limits the strength and comparability of findings, highlighting the need for standardized protocols and long-term randomized studies.