Could the application of bioactive molecules improve vital pulp therapy success? A systematic review

This study aimed to systematically review the literature of animal studies to evaluate whether bioactive dentin proteins could improve vital pulp therapy success. The review is reported in accordance with the PRISMA Statement. Two reviewers independently conducted a literature search of seven databases: PubMed (Medline), Lilacs, IBECS, BBO, Web of Science, Scopus, and SciELO. Animal experiments in which bioactive dentin proteins were applied directly or indirectly to the pulp tissue were included. Data regarding the characteristics of the proteins evaluated, the delivery systems used and the main findings from each study were tabulated to assess the outcomes of interest (tertiary dentin formation, inflammatory response, intratubular mineralization). After screening, 32 papers were subjected to qualitative analysis. In 75% of the studies, direct pulp capping was performed. Additionally, the most studied proteins were BMP-7, TGF-β1, and extracted soluble dentin matrix proteins. In conclusion, there is evidence in the literature suggesting that bioactive dentin molecules could enhance tertiary dentin formation with fewer initial inflammatory responses in direct and indirect pulp therapy in animal models. There are potential areas to be explored for novel therapeutic approaches for dental tissue repair and regeneration with bioactive materials. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 941-956, 2017.