Background and aims: The role of recent therapeutic procedures in regenerative endodontic and increasing the success rate is not defined clearly. The aim of this study was to compare recent therapeutic procedures in immature necrotic permanent teeth with conventional apexification.

Methods: PubMed, Embase, Web of Science, Scopus and the Cochrane Library were searched and relevant studies were included by hand-searching and all of the included study restricted to English language. Type of study to be included was randomized controlled trials on animals.

Data extraction: Searches resulted in the identification of 73 articles, and after removing duplicates and studies not meeting inclusion criteria like case reports and case series, 7 studies were selected quality assessment of the randomized controlled trials was executed by using the Critical Appraisal Skills Programme (CASP). Eventually 6 of these studies were selected for meta-analysis by Comprehensive meta-analysis version 2.

Results: Among all detected studies 6 were included to meta-analysis and it shows increase in root length and dentinal wall thickness. Radiographic evaluation significantly shows this increase (Z=2.36, P=0.01, OR=4.71, 95% CI: 1.34–12.92, I=0%) in comparison of control and experimental groups. Heterogeneity was not detected (I<25%). The risk of bias in selected studies were low.

Conclusion: Recent therapies in regenerative endodontics show high level of evidence on root length and dentinal wall thickness but more clinical evidence such as randomized clinical trials on human is needed.