Regenerative Endodontics and Stem Cell-Based Therapies - A Systematic Review

Traditional root canal treatment removes the infection successfully, but the vitality of pulp-dentin complex cannot be restored. The birth of regenerative endodontics is a biologically driven technique that seeks to restore pulp vitality, coax the root into forming, and maintain long-term functionality of the tooth. This review critically appraises the available evidence regarding regenerative endodontics and stem cell-based therapies in clinical practice. PRISMA guidelines were adopted for a comprehensive search of the literature in PubMed, Scopus, Web of Science, Cochrane Library, and Embase. Human trials reporting cellular transplantation-based or cell-homing regenerative approaches were considered. Five eligible human studies were included. Stem cell sources comprised dental pulp stem cells and stem cells from human exfoliated deciduous teeth, while platelet concentrates and collagen scaffolds were commonly used. Clinical outcomes included restoration of pulp vitality, apical closure, dentin wall thickening, and periapical healing, with no major adverse events reported. Stem cell-based regenerative endodontics demonstrates promising clinical potential but remains constrained by small sample sizes, protocol heterogeneity, and limited follow-up. Standardized methodologies and long-term randomized controlled trials are needed before integration into routine practice.