Potential impact of low-level laser therapy on Wnt/β-catenin signaling pathway for regenerative endodontic applications: A literature review.

Regenerative endodontics seeks to restore the structure and function of the pulp-dentin complex by harnessing endogenous or transplanted stem cells, bioactive signals, and scaffold-based microenvironments. Among the candidate biologic regulators, the canonical Wnt/β-catenin pathway is pivotal in pulp homeostasis, odontogenic differentiation, and dentin regeneration. Low-level laser therapy (LLLT), also termed photobiomodulation, has emerged as a non-invasive adjunct capable of modulating cell proliferation, viability, migration, and lineage commitment. This review synthesizes current knowledge on Wnt/β-catenin signaling in pulp regeneration and evaluates whether LLLT may influence this pathway to enhance regenerative endodontic outcomes. Wnt ligands, membrane receptors, and intracellular effectors coordinate odontogenic repair through canonical and non-canonical signaling. In dental stem cells, Wnt activity promotes proliferation and migration, while prolonged activation or context-dependent signaling can alter mineralization. LLLT has repeatedly been shown to improve dental pulp stem cell survival, proliferation, migration, and odontogenic/osteogenic differentiation, with effects varying by wavelength, fluence, timing, and nutritional context. Emerging evidence suggests crosstalk between LLLT-responsive pathways, especially Wnt/β-catenin, BMP/Smad, ERK1/2, and growth factor signaling. However, direct evidence connecting LLLT to Wnt/β-catenin activation in human dental pulp stem cells and stem cells from the apical papilla remains limited. LLLT is a biologically plausible adjuvant for regenerative endodontics, potentially acting in part through Wnt/β-catenin-dependent mechanisms. Well-designed mechanistic and translational studies are needed to define optimal irradiation parameters and confirm pathway-specific effects in clinically relevant dental stem cell models.