Clinical considerations of regenerative processes in bucomaxillofacial surgery using stem cells from exfoliated deciduous teeth: a systematic review

Abstract

Introduction: The World Health Organization forecasts that road accidents will be the third cause of facial trauma worldwide by 2025. To catalyze regenerative processes in oral and maxillofacial surgery, human oral mesenchymal stem cells (Stem Cells from Exfoliated Deciduous Teeth - SHEDs) have been discovered near the oral mucosal tissues and primary teeth. Objective: It was to analyze the main clinical considerations of regenerative processes in bucomaxillofacial surgery using stem cells from exfoliated deciduous teeth. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from July to August 2025 in the Web of Science, Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument.  Results and Conclusion: According to the GRADE instrument, most studies presented homogeneity in their results, with X2=78.7%>50%. A total of 122 articles were found and submitted to eligibility analysis, with 14 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 29 studies that did not meet GRADE and AMSTAR2. The conclusion was that the integration of SHED cells with scaffolds consistently improves alveolar and maxillary bone regeneration compared to scaffold-only approaches, resulting in increased bone volume, density, osteogenesis, and angiogenesis. Thus, SHEDs have emerged as a promising alternative in regenerative and reconstructive medicine. These stem cells exhibit high differentiation potential and self-renewal capacity. These stem cells can be easily harvested from accessible and numerous sources, such as molars and extracted baby teeth, with minimal invasiveness, playing essential roles in clinical applications and pointing to the overcoming of complex challenges in restorative and reconstructive medicine