Use of bioactive agents in the regeneration and protection of the dentin-pulp complex: a narrative literature review

Abstract

The dentin–pulp complex is essential for maintaining tooth vitality, acting jointly in defense, nutrition, sensitivity, and tissue formation. When exposed to deep caries or trauma, the pulp may develop inflammatory responses that can progress to irreversible damage. In this context, bioactive materials have gained prominence for their ability to interact with tissues and stimulate reparative and regenerative processes. Calcium silicate–based cements, such as MTA and Biodentine, are widely used due to their biocompatibility and bioinductive potential. This study aimed to analyze, through a narrative literature review, the role of bioactive agents in the regeneration and protection of the dentin-pulp complex, considering their biological effects and clinical efficacy in conservative therapies. A search for articles was carried out in the databases PubMed, SciELO, and Google Scholar, using the Health Sciences Descriptors (DeCs): "Biomaterial; Dental Pulp; Regeneration; Conservative Therapy". The search for articles was carried out in the second half of 2025, allowing the selection of 16 articles published in the last ten years, in Portuguese or English. It was observed that bioactive agents—particularly calcium silicate–based cements—exhibited favorable properties such as ion release, growth factor stimulation, high biocompatibility, angiogenic potential, and odontogenic induction. They promoted dentin bridge formation, reduced inflammation, and maintained pulp vitality, outperforming traditional materials. It was therefore concluded that bioactive agents represent a promising approach in contemporary dentistry, capable of promoting effective repair and regeneration of the dentin–pulp complex, reinforcing the relevance of these biomaterials in vital pulp therapy and regenerative dentistry. 

Keywords: Biocompatible Materials; Dental Pulp; Regenaration; Conservative Treatment.