What the paper reports
Rosa Baldeon-Gutierrez, Masahiko Terajima, Yuria Hori and ten colleagues, mostly at Asahi University School of Dentistry in Gifu and Kagoshima University, have published a narrative review comparing stem cells from human exfoliated deciduous teeth (SHEDs) and dental pulp stem cells (DPSCs) for cell-based vital pulp therapies (CB-VPTs) and cell-based regenerative endodontic procedures (CB-REPs). It appeared in the Journal of Clinical Medicine, volume 15, issue 20, article 8162, on 20 October 2026 (DOI 10.3390/jcm15208162, PubMed 42941676, open access at the publisher). The authors searched PubMed/MEDLINE, Scopus, Web of Science, and Embase for work published between January 2000 and June 2026, and they grade each cited study on a five-level translational scale: in vitro work, preclinical animal studies, case reports and series, pilot clinical studies, and randomized trials. The review is explicit that it is narrative, with single-author study selection, and that this limits reproducibility.
What the evidence shows
The load-bearing numbers all come from a small set of studies the review re-examines. In a dog pulpotomy model (Jia et al. 2016, J Endod 42:1049), pulp-like tissue filled 76.8 percent of the cavity after DPSC transplantation versus 47.3 percent in controls, and 85.8 percent when simvastatin was added. Two dog direct-pulp-capping studies (Abdelaz et al. 2019; Hemdan et al. 2022) reported odontoblast regeneration and dentin whose calcium and phosphorus content matched normal dentin, unlike the calcium hydroxide controls. On the clinical side, the Nakashima group’s pilot transplant of DPSCs into five teeth with irreversible pulpitis (Stem Cell Res Ther 2017, 8:61) produced lateral dentin formation in three of five patients at 24 weeks on CBCT, positive electric pulp testing in four evaluable patients, and MRI signal approaching normal pulp, but without histology. The one randomized trial remains Xuan et al. 2018 (Sci Transl Med 10:eaaf3227): autologous SHED transplantation in necrotic immature permanent teeth outperformed apexification on root elongation, dentin thickness, and apical closure at 12 months, and its only human histology came from a single re-traumatized tooth. The review also records two facts that are easy to miss: no study using SHEDs for cell-based vital pulp therapy has been reported at all, and one of the first direct histological comparisons in an autologous dog model (Ziauddin et al. 2022, Stem Cell Res Ther 13:439) found SHEDs and DPSCs produced comparable pulp-like tissue in vivo even though SHEDs show higher proliferative and angiogenic activity in vitro.
What it does not show
This is a review of heterogeneous work, not new experiments, and its own conclusion is that the evidence does not allow a call on which cell type is better. Nearly all comparative claims rest on different labs, different scaffolds, different species, and different endpoints; the review warns that cross-study differences must not be read as superiority or equivalence of either cell. Human histological evidence of regenerated pulp covers exactly one tooth, in the Xuan trial’s re-trauma case. The clinical series are tiny: five patients in the Nakashima pilot, two case reports covering three patients with mature permanent teeth (J Endod 2022, 48:1334; J Endod 2024, 50:189), and a single two-patient case report of allogeneic SHEDs with no immune-compatibility data. No adverse effects were reported in the clinical studies cited, but the review itself stresses that these cohorts are small, follow-up is short, and long-term safety after cell transplantation remains uninvestigated.
Where it sits in the field
For the pulp and dentin repair program, the paper’s practical contribution is a map of what would have to be true before cell choice matters: standardized isolation and expansion under GMP, settled scaffold and delivery choices (the reviewed protocols span atelocollagen sponges, hyaluronic acid carriers, gelatin sponge, and one scaffold-free protocol that moves pulp tissue directly from a deciduous donor tooth), and powered comparative trials with histological endpoints. It also sharpens the field assessment: the strongest cell-level claims (SHEDs’ proliferation, angiogenesis, and macrophage M2 polarization advantages) are Level 1 and 2 evidence, while the strongest human evidence, the Xuan trial, predates nearly all of the mechanism work and cannot say which cell type drove its result.
Where we differ from the coverage
We found no press coverage of this review to differ from. Against the abstract’s even-handed framing of both cell types as “promising candidates,” we would note the asymmetry the review documents but does not headline: for vital pulp therapy specifically, the entire cell-based evidence base is DPSCs in dogs, for regenerative procedures in necrotic teeth the only randomized evidence is SHEDs in immature permanent teeth, so “SHED or DPSC” is not yet a real clinical choice anyone has tested head to head in a patient.
Provenance: source read in full (open-access full text at the publisher, article 8162; author list, publication date, and PubMed index 42941676 confirmed against Crossref and NCBI). Every number above is as reported in the review or in the primary study it cites, with the primary linked. Selection and review procedure: /method/.