Regenerative potential of human dental pulp stem cells in scaffold-based alveolar and jaw bone reconstruction: a systematic review

Background: Effective alveolar and jaw bone regeneration remains a clinical challenge, and the added value of incorporating human dental pulp stem cells (hDPSCs) or stem cells from exfoliated deciduous teeth (SHED) into scaffolds over traditional cell-free approaches has not been systematically evaluated in vivo, limiting evidence-based advancements in regenerative dental therapies. This review aimed to evaluate the outcomes of human dental pulp stem cells in conjunction with scaffolds for the regeneration of alveolar and jaw bone. Materials and methods: This systematic review followed PRISMA guidelines and used the PICO framework. A comprehensive search was conducted in PubMed, Scopus, Embase, Web of Science, the Cochrane Library, and Google Scholar through April 2025, focusing on studies using human dental pulp stem cells and scaffolds for alveolar and jaw bone regeneration in animal models. Inclusion criteria were restricted to English-language in vivo trials that compared cell-free scaffolds with those incorporating hDPSCs or SHED in conjunction with scaffolds. Risk of bias was assessed with a modified CAMARADES tool. The review is registered with PROSPERO (CRD420250655330). Results: Nineteen studies fulfilled the inclusion criteria. Among these, 8 studies concentrated on bone regeneration using SHED, while 11 investigated DPSCs obtained from permanent teeth. The findings revealed that scaffolds seeded with DPSCs achieved new bone formation rates ranging from 0.2 to 70.5%, whereas scaffolds seeded with SHED exhibited 32.64% and 40% regeneration rates. Conclusions: Integrating human DPSCs or SHED with scaffolds consistently improves alveolar and jaw bone regeneration over scaffold-only approaches, enhancing bone volume, density, osteogenesis, and angiogenesis and showing strong potential for future clinical use. Clinical trial number: Not applicable.