Cell Homing: Pioneering Regenerative Solutions in Endodontics

Abstract BACKGROUND: Regenerative endodontics aims to restore the vitality and function of teeth affected by pulp necrosis through biological tissue regeneration. Traditional apexification techniques, though effective in forming an apical barrier, often result in limited root development and weak dentinal walls. The emergence of cell homing – a cell-free regenerative strategy – has introduced a new paradigm by recruiting endogenous stem/progenitor cells to the site of injury, eliminating the need for exogenous cell transplantation. METHODS: A comprehensive review of current literature was conducted to analyze the mechanisms, signaling pathways, and scaffold designs involved in the cell-homing approach to regenerative endodontics. Studies focusing on the role of chemokines, growth factors, and bioactive scaffolds in promoting endogenous cell migration and differentiation within the pulp–dentin complex were evaluated in alignment with the American Association of Endodontists clinical protocols. RESULTS: Cell homing utilizes biological signaling molecules such as stromal cell-derived factor-1, vascular endothelial growth factor, and bone morphogenetic proteins to guide endogenous stem cells toward the damaged pulp tissue. Engineered scaffolds – composed of biomaterials such as collagen, chitosan, and poly(lactic-co-glycolic acid) – support cellular adhesion, proliferation, and differentiation. Preclinical and clinical data demonstrate promising outcomes in pulp–dentin regeneration, root maturation, and apical closure. The integration of three-dimensional printing, hydrogel-based scaffolds, and controlled release systems further enhances regenerative efficacy. CONCLUSIONS: Cell homing represents a minimally invasive and clinically feasible alternative to cell transplantation for dental pulp regeneration. Continued advancements in biomaterials, growth factor delivery, and imaging technologies are critical for translating preclinical findings into standardized clinical protocols. This strategy holds substantial promise for promoting biological root development and maintaining long-term tooth vitality.