Regeneration of the dentin-pulp complex in vital pulp therapy: biological basis, biomaterials, and clinical...

Vital pulp therapy has traditionally aimed to preserve pulp vitality; however, conventional approaches primarily induce reparative dentin formation rather than true regeneration of the dentin-pulp complex. Advances in regenerative medicine have shifted this paradigm toward biologically driven reconstruction targeting both structural and functional restoration. This mini-review provides a translational overview of dentin-pulp complex regeneration, integrating stem/progenitor cell biology, angiogenesis, neurogenesis, immune modulation, growth factor signaling, and biomaterial-based strategies. Particular emphasis is placed on distinguishing repair from functional regeneration and conceptualizing regeneration as a biological continuum. Recent advances in bioactive scaffolds, controlled-release systems, and three-dimensional biofabrication are highlighted as key to regulating the regenerative microenvironment. Biologically stratified approaches based on pulpal condition and residual tissue viability are discussed to improve predictability. Although emerging studies support the feasibility of regenerative strategies, direct comparative evidence with conventional vital pulp therapy remains limited, and current outcome measures are not fully aligned with functional restoration. Standardized evaluation criteria and integration with preventive care are essential for advancing clinical translation.