Photobiomodulation and the Wnt/β-catenin pathway in apexogenesis: Rationale and evidence gaps
4 affiliations
- 1Department of Orthodontics, School of Dentistry, Iran University of Medical Sciences, Tehran, Iran; Corresponding author at: Department of Orthodontics, School of Dentistry, Iran University of Medical Sciences, Tehran, Iran.
- 2Department of Pediatric Dentistry, School of Dentistry, Iran University of Medical Sciences, Tehran, Iran
- 3Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Corresponding author at: Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- 4Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Apexogenesis is a vital pulp therapy that preserves vascularized pulp in immature teeth and relies on dental pulp stem cells (DPSCs) and stem cells from the apical papilla (SCAPs) for continued root growth and apical closure. Wnt/β-catenin signaling has an established role in odontoblast differentiation, reparative dentinogenesis, and root development, although normal root development requires regulated rather than simply increased Wnt activity. Photobiomodulation therapy (PBMT) is proposed to act through mitochondrial photoreception, and in vitro studies report increased expression of odontogenic/osteogenic markers and angiogenic factors (VEGF, TGF-β2) in DPSCs and SCAPs. Because these markers overlap with Wnt/β-catenin targets, a link between PBMT and this pathway has been hypothesized but not tested in these cells. This review addresses three questions: the role of Wnt/β-catenin signaling in root development and dentin repair; the mechanism that could link PBMT to this pathway; and the in vitro evidence for PBMT effects on DPSCs and SCAPs and its consistency. The evidence is heterogeneous and limited. Increased odontogenic/osteogenic differentiation was the most consistent finding. Reported effects on ''proliferation'' were inconsistent and were estimated mainly by MTT, a metabolic assay that does not measure cell division; no study used a clonogenic assay, and only one performed direct cell counts. No superior wavelength or fluence was identified. No study has examined PBMT-induced modulation of Wnt/β-catenin signaling in DPSCs or SCAPs, and the markers involved are not pathway-specific. Therapeutic benefit in apexogenesis therefore remains unproven; direct mechanistic studies, light-delivery studies through dentin, and animal models are priorities.
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BibTeX
@article{bahrami2026photobiomodulation,
title = {{Photobiomodulation and the Wnt/β-catenin pathway in apexogenesis: Rationale and evidence gaps}},
author = {Rashin Bahrami and Zahra Kiyamehr and Maryam Pourhajibagher and Abbas Bahador},
journal = {Photodiagnosis and Photodynamic Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.pdpdt.2026.105693},
url = {https://doi.org/10.1016/j.pdpdt.2026.105693},
note = {CC BY},
}
RIS
TY - JOUR
TI - Photobiomodulation and the Wnt/β-catenin pathway in apexogenesis: Rationale and evidence gaps
AU - Rashin Bahrami
AU - Zahra Kiyamehr
AU - Maryam Pourhajibagher
AU - Abbas Bahador
PY - 2026
DA - 2026/10/30
JO - Photodiagnosis and Photodynamic Therapy
DO - 10.1016/j.pdpdt.2026.105693
UR - https://doi.org/10.1016/j.pdpdt.2026.105693
AB - Apexogenesis is a vital pulp therapy that preserves vascularized pulp in immature teeth and relies on dental pulp stem cells (DPSCs) and stem cells from the apical papilla (SCAPs) for continued root growth and apical closure. Wnt/β-catenin signaling has an established role in odontoblast differentiation, reparative dentinogenesis, and root development, although normal root development requires regulated rather than simply increased Wnt activity. Photobiomodulation therapy (PBMT) is proposed to act through mitochondrial photoreception, and in vitro studies report increased expression of odontogenic/osteogenic markers and angiogenic factors (VEGF, TGF-β2) in DPSCs and SCAPs. Because these markers overlap with Wnt/β-catenin targets, a link between PBMT and this pathway has been hypothesized but not tested in these cells. This review addresses three questions: the role of Wnt/β-catenin signaling in root development and dentin repair; the mechanism that could link PBMT to this pathway; and the in vitro evidence for PBMT effects on DPSCs and SCAPs and its consistency. The evidence is heterogeneous and limited. Increased odontogenic/osteogenic differentiation was the most consistent finding. Reported effects on ''proliferation'' were inconsistent and were estimated mainly by MTT, a metabolic assay that does not measure cell division; no study used a clonogenic assay, and only one performed direct cell counts. No superior wavelength or fluence was identified. No study has examined PBMT-induced modulation of Wnt/β-catenin signaling in DPSCs or SCAPs, and the markers involved are not pathway-specific. Therapeutic benefit in apexogenesis therefore remains unproven; direct mechanistic studies, light-delivery studies through dentin, and animal models are priorities.
SN - 1572-1000
SN - 1873-1597
ER -