Engineered biomaterial-based scaffolds for dentin-pulp complex regeneration: applications and biological...

To map and summarize scientific evidence on engineered scaffolds for dentin-pulp complex regeneration. This scoping review followed the PRISMA-ScR guidelines and was registered in the Open Science Framework. Systematic searches were conducted in PubMed, Embase, Scopus, and Web of Science, complemented by grey literature searches. In vitro, in situ, and in vivo studies that evaluated scaffolds or other biomaterial-based strategies for guided tissue regeneration in the dentin-pulp complex were included. Two reviewers independently performed study selection, data extraction, and qualitative descriptive synthesis. Of the 357 records identified after duplicate removal, 44 met the inclusion criteria and were included in the qualitative synthesis. Most were in vitro studies, followed by combined in vitro/in vivo and in vivo animal studies. The scaffolds included synthetic polymers, natural biomaterials, bioceramics, hybrid systems, and extracellular matrix-derived materials. Lyophilization and electrospinning were the most common fabrication techniques, although 3D printing, bioprinting, injectable systems, and self-assembling platforms were also explored. Overall, the studies showed favorable cytocompatibility, supporting cell adhesion, proliferation, migration, odontogenic differentiation, mineralized matrix deposition, and angiogenic potential. Bioactive functionalization further enhanced regenerative performance, while antimicrobial approaches demonstrated activity against clinically relevant endodontic pathogens and inhibition of biofilm formation. In vivo findings supported the formation of vascularized pulp-like tissue and dentin-like or mineralized structures, although the overall evidence remains predominantly preclinical. Scaffolds show potential for dentin-pulp regeneration by providing structural support and bioactive cues. Natural, synthetic, and hybrid systems consistently promote differentiation, mineral deposition, and pulp-like tissue formation.