Stem Cell-Based Regeneration of Immature Permanent Teeth: A Comprehensive Review | ||||
| Misr Dental Science and Research Journal | ||||
| Article 1, Volume 2, Issue 1, July 2025, Page 1-8 PDF (291.08 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mdsrj.2025.443673 | ||||
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| Abstract | ||||
| The regeneration of immature permanent teeth with necrotic pulps presents a major challenge in endodontic practice due to incomplete root development, open apices, and fragile dentinal walls. Traditional treatments, such as apexification with calcium hydroxide or mineral trioxide aggregate (MTA), provide apical closure but fail to promote continued root maturation. In recent years, regenerative endodontic procedures (REPs) have emerged as a biologically based alternative, aiming not only to disinfect the canal but also to restore the pulp-dentin complex by stimulating tissue regeneration. Central to this approach is the use of stem cells, which provide the cellular basis for regeneration. This review explores the pivotal role of stem cells in the regeneration of immature permanent teeth. We examine the biological principles underlying REPs, including the regenerative triad of stem cells, signaling molecules, and scaffolds. Particular emphasis is placed on stem cells from the apical papilla (SCAP), dental pulp stem cells (DPSCs), and periodontal ligament stem cells (PDLSCs), which have demonstrated the potential to differentiate into odontoblast-like cells and contribute to tissue regeneration. Current clinical protocols, including disinfection strategies, induction of bleeding, and scaffold placement, are discussed alongside the clinical outcomes reported in the literature. Despite promising results, challenges remain, including variability in outcomes, limited long-term data, and ethical concerns related to stem cell use. Advances in stem cell engineering, bioactive scaffolds, and cell-free approaches such as exosome therapy are poised to refine and expand the scope of regenerative endodontics. This review highlights the current state of stem cell-based regeneration, evaluates its clinical potential, and outlines future directions aimed at achieving predictable, functional regeneration of immature permanent teeth. | ||||
| Keywords | ||||
| Stem cells; regeneration; immature permanent; necrotic pulp | ||||
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