Document Type : Literature Review
Authors
1 Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
2 Dept. of Endodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran .
3 Research Fellow, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Abstract
Regenerative endodontic procedures have emerged as a biologically based approach to restore the structure and function of the pulp-dentin complex, primarily through the interplay of stem cells, bioactive signaling molecules, and scaffolds. Scaffolds provide a temporary three-dimensional matrix for cell adhesion, proliferation, differentiation, and vascularization. An ideal scaffold should be bioactive, biodegradable, structurally stable, immunocompatible, and architecturally suitable for tissue regeneration. This review synthesizes recent in vitro and in vivo studies, clinical trials, and case reports on natural, synthetic, and composite scaffolds applied in pulp-dentin regeneration. A literature search was performed in PubMed, Scopus, and Google Scholar up to 2025. Scaffolds were classified according to their origin, structural form, and cellular integration. The review showed that while natural scaffolds demonstrate favorable biocompatibility and clinical outcomes, their mechanical limitations often restrict their performance. Conversely, synthetic scaffolds offer tunable properties but may lack inherent bioactivity. Composite materials and biofunctionalized hydrogels may help integrate the strengths of both scaffold classes. Despite encouraging experimental data, further well-designed clinical studies are needed to optimize scaffold-based strategies for reliable translation into clinical endodontics.
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