Bioactive Materials in Vital Pulp Therapy: Promoting Dental Pulp Repair Through Inflammation Modulation

With the paradigm shift towards minimally invasive biologic therapies, vital pulp therapy (VPT) has been receiving increasing attention. Currently, bioactive materials (BMs), including MTAs, Biodentine, Bioaggregate, and iRoot BP Plus, are clinically widely used for the repair of damaged pulp tissue. Emerging evidence highlights the crucial role of inflammation in pulp repair, with mild to moderate inflammation serving as a prerequisite for promoting pulp repair. BMs play a pivotal role in regulating the balance between inflammatory response and reparative events for dentine repair. Despite their widespread application as pulp-capping agents, the precise mechanisms underlying the actions of BMs remain poorly understood. A comprehensive literature review was conducted, covering studies on the inflammatory responses induced by BMs published up to December 2023. Sources were identified through searches of PubMed and MEDLINE databases, supplemented by manual review of cross-references from relevant studies. The purpose of this article is to discuss diverse mechanisms by which BMs may regulate the balance between tissue inflammation and repair. A deeper understanding of these regulatory mechanisms will facilitate the optimization of current pulp-capping agents, enabling the development of targeted regenerative strategies to achieve superior clinical outcomes.