Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences

Preserving Vital Pulp Versus Complex Regeneration: Ethical and Clinical Considerations in Exosome-Based Endodontic Therapy

Articles InPress

Document Type : Letter(s) to the Editor

Author

Saeed Asgary

Iranian Centre for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

10.30476/ijms.2026.110774.4655
Abstract
I read with interest the recent case report by Jafari and colleagues describing the use of exosomes derived from human umbilical cord mesenchymal stromal/stem cells (hUCMSCs) in a mandibular premolar diagnosed with irreversible pulpitis and treated with pulpectomy.

Highlights

 Saeed Asgary (Google Scholar)

Keywords

Vital pulp therapy
Exosome therapy
Irreversible pulpitis
Regenerative endodontics
Ethical considerations
  1. Jafari N, Seyed Habashi M, Afshar A, Ghasemi M, Kurmanalina MA, Mussin NM, et al. The Effect of Exosomes Derived from Human Umbilical Cord Mesenchymal Stromal/Stem Cells on the Regeneration of Human Pulpectomized Tooth: A Case Report. Iran J Med Sci. 2025;50:54-8. doi: 10.30476/ijms.2024.103117.3638. PubMed PMID: 39957811; PubMed Central PMCID: PMC11829066.
  2. Shi J, Teo KYW, Zhang S, Lai RC, Rosa V, Tong HJ, et al. Mesenchymal stromal cell exosomes enhance dental pulp cell functions and promote pulp-dentin regeneration. Biomater Biosyst. 2023;11:100078. doi: 10.1016/j.bbiosy.2023.100078. PubMed PMID: 37283805; PubMed Central PMCID: PMC10239699.
  3. Asgary S, Nosrat A. Vital Pulp Therapy: Evidence-Based Techniques and Outcomes. Iran Endod J. 2025;20:e2. doi: 10.22037/iej.v20i1.47141. PubMed PMID: 39935864; PubMed Central PMCID: PMC11808331.
  4. Santos JM, Pereira JF, Marques A, Sequeira DB, Friedman S. Vital Pulp Therapy in Permanent Mature Posterior Teeth with Symptomatic Irreversible Pulpitis: A Systematic Review of Treatment Outcomes. Medicina (Kaunas). 2021;57. doi: 10.3390/medicina57060573. PubMed PMID: 34205149; PubMed Central PMCID: PMC8228104.
  5. Asgary S, Roghanizadeh L, Eghbal MJ, Akbarzadeh Baghban A, Aminoshariae A, Nosrat A. Outcomes and predictive factors of vital pulp therapy in a large-scale retrospective cohort study over 10 years. Sci Rep. 2024;14:2063. doi: 10.1038/s41598-024-52654-8. PubMed PMID: 38267594; PubMed Central PMCID: PMC10808198.
Iranian Journal of Medical Sciences

Articles InPress, Corrected Proof
Available Online from 01 September 2026


  • Received 16 February 2026
  • Revised 16 May 2026
  • Accepted 20 May 2026

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