Evidence map›Paper›PMID 41733701›Full record

SynthesisMolecular biology reports2026

Efficacy of dental stem cell-derived exosomes for pulp regeneration: a systematic review of clinical, animal, and in vitro studies.

Julia Godoi-Lopes, Victor Hugo Alves Ribeiro-Silva, Larissa Gregório Candido do Prado, Igor Bassi Ferreira Petean, Lais Valencise Magri, Fabiane Carneiro Lopes-Olhê, Carla Renata Sipert, Jardel Francisco Mazzi-Chaves

Erratum issuedAbstract readSystematic Review
In one paragraph

Synthesis in Molecular biology reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Julia Godoi-LopesDepartment of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-3692-8164
Victor Hugo Alves Ribeiro-SilvaDepartment of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0009-0003-4420-6457
Larissa Gregório Candido do PradoDepartment of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0009-0006-7132-0951
Igor Bassi Ferreira PeteanDepartment of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-2704-5730
Lais Valencise MagriDepartment of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0001-8050-4396
Fabiane Carneiro Lopes-OlhêDepartment of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0003-4375-3371
Carla Renata SipertDepartment of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-5719-6505
Jardel Francisco Mazzi-ChavesDepartment of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. jardel.chaves@usp.br.ORCID http://orcid.org/0000-0002-9889-1790

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Exosomes derived from dental stem cells (DSC-Exos) are nanovesicles (~ 30–150 nm) that mediate angiogenesis, odontoblastic differentiation, and immune regulation, positioning them as promising cell-free candidates for pulp–dentin regeneration. This PROSPERO-registered systematic review evaluated the regenerative potential of DSC-Exos and the methodological factors influencing outcomes. A comprehensive search of PubMed, Scopus, Web of Science, and Embase was conducted through July 2025; risk of bias was assessed using RoB 2.0, SYRCLE, and QUIN tools. Thirteen studies fulfilled the inclusion criteria, most of which employed exosomes derived from human dental pulp stem cells, stem cells from human exfoliated deciduous teeth and stem cells from the apical papilla. DSC-Exos consistently promoted cell proliferation and migration while upregulating odontogenic (DSPP, DMP1) and angiogenic (VEGF, CD31) markers. Animal models demonstrated vascularized pulp-like tissue and organized tubular dentin formation, significantly enhanced by donor-cell preconditioning and biodegradable carriers. Mechanistic investigations linked these outcomes to noncoding RNAs and signaling axes like miR-26a/TGF-β and circ_0003057/EIF4A3/ANKH. A 24-month clinical pilot confirmed restored pulp sensitivity without safety concerns. Nevertheless, the overall certainty of evidence remains moderate to low, mainly due to substantial methodological heterogeneity, limited sample sizes and insufficient reporting of critical parameters such as exosome characterization, dosing strategies and operator calibration. Collectively, the findings indicate that DSC-Exos represent a high-potential biomimetic strategy for pulp–dentin regeneration; however, standardized characterization protocols in line with MISEV guidelines, dose harmonization and well-designed long-term controlled clinical trials are essential before cell-free endodontic therapies can be reliably incorporated into clinical practice.

Indexed as

Dental PulpExosomesRegenerationStem CellsAnimalsCell DifferentiationCell ProliferationHumansDental pulp stem cellsExosomesPulp–Dentin complexRegenerative endodontics

Identifiers

PMID41733701
PMCPMC12932340

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.