Differences in Pulp Wound Healing and Regenerative Potential Between SHEDs and DPSCs

Several challenges limit effective pulp wound healing during vital pulp therapies (VPTs) and pulp regeneration in necrotic teeth. Recent advances in regenerative therapies using dental mesenchymal stem cells (MSCs) have shown promise for improving tissue repair and expanding minimally invasive treatment strategies. Among these cells, stem cells from human exfoliated deciduous teeth (SHEDs) and dental pulp stem cells (DPSCs) have gained attention for cell-based VPTs (CB-VPTs) and cell-based regenerative endodontic procedures (CB-REPs). However, little is known about whether SHEDs or DPSCs perform better in CB-VPTs and CB-REPs, particularly regarding wound healing and dentin-pulp regeneration. To date, few studies have compared SHED and DPSC outcomes; separately, CB-VPTs and CB-REPs have shown promising outcomes with both cell types. Dentin bridge formation was generally observed following cell-free approaches, whereas recent in vivo studies of CB-VPTs and CB-REPs have additionally demonstrated the formation of pulp-like tissue. Histological analysis in animal models has identified odontoblasts, angiogenesis, neurogenesis, and connective tissue following CB-REPs using SHEDs or DPSCs. In humans, histological evidence of pulp-like tissue regeneration after SHED CB-REPs has been reported in a single patient. Collectively, preclinical findings and limited clinical evidence suggested that CB-REPs may support injury resolution accompanied by histological regeneration of pulp-like tissue. Both SHEDs and DPSCs represent promising candidates for CB-VPTs and CB-REPs; however, further comparative studies and randomized clinical trials are needed to strengthen the evidence on clinical effectiveness. This review examines the biological properties and regenerative potential of SHEDs and DPSCs within the dentin-pulp complex.