Dental Pulp Stem Cells for the Management of Plaque Biofilm-Associated Infections : A Review

This structured narrative review synthesises current evidence (2000-2025) on the antimicrobial, immunomodulatory, and regenerative properties of dental pulp stem cells (DPSCs) in the context of plaque-induced gingivitis and oral biofilm infections. We systematically reviewed peer-reviewed literature from PubMed, Scopus, and Web of Science via keywords related to DPSCs, oral biofilms, antimicrobial peptides (eg, β-defensins, LL-37), and immunomodulation. Unlike conventional antimicrobial therapies that solely target pathogen eradication, DPSCs offer a dual-function strategy: (1) direct microbial control through the secretion of antimicrobial peptides that disrupt Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans and (2) resolution of inflammation via macrophage M2 polarisation, suppression of IL-1β/TNF-α (Interleukin-1β and Tumor Necrosis Factor-α), and microbiome rebalancing. Additionally, DPSCs support periodontal tissue regeneration through trophic signalling and differentiation into periodontal lineage cells. Critically, no clinical trials to date have evaluated DPSCs for the management of gingivitis. This review highlights DPSCs as promising, antibiotic-sparing therapeutic candidate and outlines key knowledge gaps for future translational research.