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

Area of Science:

• Dentistry
• Regenerative Medicine
• Biomaterials

Background:

• Traditional root canal therapy effectively removes infection but fails to restore pulp-dentin complex vitality.
• Regenerative endodontics aims to revitalize the pulp, promote root development, and ensure long-term tooth function.
• Stem cell-based therapies are emerging as a key approach in regenerative endodontics.

Purpose of the Study:

• To critically review the existing evidence on regenerative endodontics and stem cell therapies in clinical settings.
• To evaluate the efficacy and safety of current regenerative endodontic procedures based on human trials.

Main Methods:

• A comprehensive literature search was conducted following PRISMA guidelines across major databases (PubMed, Scopus, Web of Science, Cochrane Library, Embase).
• Included human studies focused on cellular transplantation or cell-homing regenerative strategies.
• Five eligible human studies were analyzed for outcomes and adverse events.

Main Results:

• Commonly used stem cell sources included dental pulp stem cells and stem cells from exfoliated deciduous teeth.
• Platelet concentrates and collagen scaffolds were frequently employed biomaterials.
• Clinical outcomes demonstrated pulp vitality restoration, apical closure, dentin wall thickening, and periapical healing without major adverse events.

Conclusions:

• Stem cell-based regenerative endodontics exhibits significant clinical potential for tooth repair and regeneration.
• Current evidence is limited by small sample sizes, varied protocols, and insufficient long-term follow-up.
• Standardized methodologies and robust, long-term randomized controlled trials are essential for clinical integration.