What was done
Matsuki reports two cases of regenerative endodontic therapy using autologous dental pulp stem cells in mature teeth, the harder end of the indication. Both patients, aged 22 and 28, had maxillary anterior teeth that were nonvital, previously endodontically treated, and affected by persistent apical periodontitis; one also had a cervical root perforation, sealed with mineral trioxide aggregate. After mechanical enlargement and disinfection, DPSCs isolated from each patient’s extracted third molar were transplanted with granulocyte colony-stimulating factor and atelocollagen into the disinfected root canals in both cases, and additionally into the apical perforation site in Case 2.
What was measured
The outcomes were clinical and radiographic, and they moved in the right direction. Case 1 responded positively to electric pulp testing at 4 weeks after transplantation. Case 2 first responded to both electric pulp and cold testing at 12 weeks. Radiography and cone-beam computed tomography showed mineralized tissue formation in the apical part of the root canal and remission of the periapical lesions by 48 weeks, with marked narrowing of the perforation site in Case 2. These changes were further enhanced through follow-up reaching 96 weeks, and no local or systemic adverse events were observed in either patient over that period.
How this maps to the tier ladder
This is human data, which places it above the entire preclinical literature, but it is two patients without a control group: T3 on our ladder at /method/, small and narrow human evidence. It does not raise the tier of the pulp-dentin-repair programme at /programs/pulp-dentin-repair/, which already rests on the randomized 26-patient trial of autologous pulp stem cell grafts in immature incisors recorded in the /ledger/ on 22 August 2018. What it adds is a different cell source (third molars rather than deciduous teeth) and a harder substrate (mature, previously treated, perforated roots rather than immature teeth with open apices). The author states the boundary plainly: without histological confirmation, and with only two cases, this is preliminary evidence of feasibility, not proof of pulp-dentin complex regeneration, and it requires validation in larger cohorts. Sensibility testing, it is worth remembering, measures a neural response, not regenerated pulp histology.
Where we differ from the coverage
Case reports in this space are often written up as “scientists regrow dental pulp”. The accurate version is smaller and still encouraging: in two young patients, a cell graft in a disinfected canal was followed by returning sensibility, mineralized tissue on imaging, and lesion remission sustained to 96 weeks, with no observed harm. That justifies a controlled trial in mature teeth. It does not establish that the regenerated tissue is functional pulp, that it would work in older patients, or that the perforation closure was caused by the graft rather than the MTA seal placed at the same visit.
Provenance: every claim above traces to the published abstract of Matsuki, Case Reports in Dentistry (2026), per our method at /method/.