English
The driving force behind minimally invasive dental pulp treatment strategies has shifted from technically complex and destructive root canal treatments to more conservative active pulp treatments. However, new methods for maintaining pulp vitality after disease or trauma require the development of innovative, biologically driven regenerative medicine strategies. For example, cell homing and cell-based therapies have recently been developed and tested in preclinical models to investigate pulp regeneration. These methods utilize natural and synthetic scaffolds to provide a range of bioactive pharmacological epigenetic modulators (HDACis, DNMTis, and ncRNA) that are cost-effective and easy to use for stimulating pulp tissue regeneration. Unfortunately, many biological factors hinder the clinical development of regenerative therapy, including lack of blood supply and poor control of necrotic root canal system infections. Other challenges include the demand for clinically relevant models, as well as manufacturing challenges such as scalability, cost, and regulatory issues. This review will describe the current status of engineering strategies based on bioactive biomaterials/scaffolds that stimulate dentin pulp regeneration, with a clear focus on epigenetic modulators and therapeutic pharmacological inhibition. It will focus on introducing the components of pulp regeneration methods, describing their current limitations, and providing recommendations for effectively transforming novel epigenetic bioactive materials for innovative therapies.
