Biopolymer-Based 3D Printing for Dental-Pulp Complex Tissue Regeneration: Innovations and Challenges

The regeneration of the dentin-pulp complex remains a significant challenge in regenerative endodontics. While conventional therapeutic approaches are effective in eliminating infection and preserving dental structure, they fail to restore the biological functionality of the pulp tissue. In recent years, three-dimensional (3D) printing and biopolymer-based bioprinting have opened unprecedented opportunities in dental tissue engineering, enabling the fabrication of biomimetic scaffolds with precisely controlled structural and bioactive properties. This review synthesizes current advances in bioprinting technologies, the diversity of biomaterials and bioinks employed, and the various stem cell sources utilized in pulp regeneration. It further examines how the three-dimensional microenvironment modulates cell viability, odontogenic differentiation, and the promotion of angiogenesis and neurogenesis, emphasizing the role of scaffold composition, mechanical properties, and internal architecture in influencing regenerative outcomes. Additionally, persistent challenges are discussed, including the optimization of bioink formulations, the achievement of functional vascular integration, and long-term validation of regenerated tissues, underscoring the need for multidisciplinary strategies to facilitate clinical translation. By integrating recent evidence, this review establishes a conceptual framework for the development of personalized and predictable approaches to dentin-pulp complex reconstruction.