This study evaluated the methodological quality and synthesised evidence from systematic reviews on guided tissue regeneration (GTR) in endodontic surgery. A comprehensive search across multiple databases was conducted to identify systematic reviews published up to 21 November 2024, with no language restrictions. Methodological quality was assessed using the AMSTAR-2 tool, and primary study overlap using corrected covered area (CCA) metrics. Fourteen systematic reviews, including eight meta-analyses, were included. The CCA was 12.77%, indicating high overlap, and AMSTAR-2 revealed considerable methodological variability. The use of GTR, especially the combination of bone grafts and resorbable membranes, showed improved healing outcomes in through-and-through lesions. Adjunctive use of platelet concentrates appeared to enhance postoperative recovery. However, heterogeneity in study designs and the absence of long-term follow-up limit the strength of conclusions. Overall, GTR techniques, particularly those combining grafts and membranes, show promise in endodontic surgery, but more rigorous, well-designed studies and systematic reviews are required to reinforce clinical recommendations. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42024546481.
Keywords: apicoectomy; bone regeneration; endodontics; guided tissue regeneration; systematic review.
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