Narrative review: natural scaffolds used in vital pulp therapy

Vital pulp therapy (VPT) is a modern approach to conservative treatment aimed at preserving and regenerating vital dental pulp. Its success largely depends on biomaterial scaffolds that support cell migration, differentiation, and proliferation, as well as angiogenesis and dentin regeneration. An electronic database search of PubMed, Scopus, and Google Scholar databases was conducted for publications from 2015 to 2025 using the following key words: "vital pulp therapy," "natural scaffolds," "regenerative endodontics," "dental pulp regeneration," and "pulp capping." This paper reviews current research on select natural biomaterials used in VPT, including methacry-lated gelatin, chitosan, alginate, platelet-rich fibrin, and demineralized dentin matrix. Their biological, mechanical, and antibacterial properties are discussed, alongside their potential in regenerative endodontics. Special attention is given to their biocompatibility, modifiability, and capacity for controlled bioactive agent delivery. The paper also highlights the clinical limitations of these materials, such as a lack of standardization, high costs, and technical challenges. Despite promising in vitro and in vivo results, most of these biomaterials remain in the preclinical research phase. Consequently, the need for additional clinical trials and strategies that enable their routine clinical use is emphasized.