Propolis in regenerative endodontics: A systematic review

Abstract

Aim: To systematically evaluate the role of propolis in Regenerative Endodontic Procedures (REPs), with an emphasis on its biological properties, outcomes, and clinical applicability. Method: This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature searches were performed in PubMed, Medline, and Google Scholar up to June 2025 using the keywords 'propolis' and 'regenerative endodontics.’ Eligible studies included randomized controlled trials, case reports, and in vivo studies evaluating the use of propolis in regenerative endodontic protocols. Risk of bias was assessed using the respective tools. Results: Ten studies met the inclusion criteria. Propolis has antimicrobial, anti-inflammatory, and angiogenic properties, contributing to favourable outcomes, such as increased root length, dentin thickness, and periapical healing. Clinical trials have shown comparable performance of propolis-based protocols with established medicaments such as triple antibiotic paste and mineral trioxide aggregate. Conclusions: Although propolis exhibits promising biological effects in regenerative endodontics, its composition and formulation vary, limiting its standardization and reproducibility. Further high-quality long-term clinical trials are necessary before clinical adoption.