Stem cells derived from human exfoliated deciduous teeth: a narrative synthesis of literature.

Abstract. – BACKGROUND: Stem Cells from Human Exfoliated Deciduous Teeth (SHEDs) rep- resent an immature stem cell population, easily accessible without ethical concerns, able to in- duce pluripotent stem cells and to differentiate in osteoblasts, hepatocytes, adipocytes, neural cells, chondrocytes, myocytes, skin cells and odontoblasts. AIM: The purpose of this review is to present a comprehensive synthesis of current knowl- edge of SHEDs, through the description of their tissue sources, properties, differentiation poten- tial, and comparative assessment of their advan- tages for tissue engineering. MATERIALS AND METHODS: Studies were identified by searching electronic databases (MED- LINE via PubMed, Medscape and Web of Science) from 2003 to 30 September 2013 and scanning ref- erences lists of the included publications and of the reviews. No publication date or publication sta- tus restrictions were imposed. Only evidence avail- able in English language was reviewed. RESULTS: A total of 72 studies were identified for inclusion in the review. Clinical heterogeneity didn’t allow for meta-analysis but only for a nar- rative synthesis. The outcomes of the present narrative synthesis are presented separately for methods of isolation and culture, characteriza- tion of SHEDs, differentiation in vitro and in vivo, use in animal model, and stem cell banking. CONCLUSIONS: SHEDs display multifactorial potential such as strong and high proliferative capacity, easy accessibility, high viability and multilineage differentiation capacity. Their re- trieval is relatively simple and non-invasive, no risks for developing immune reactions or rejec- tion following transplantation exist and no im- munosuppressive therapy is needed.