Arun Mayya

Three-dimensional (3D) bioprinting has emerged as a promising strategy for engineering biomimetic constructs capable of supporting regeneration of the dental pulp–dentin complex. However, the rapidly expanding literature is methodologically heterogeneous and difficult to synthesize. This scoping review aimed to map the current evidence on cell-laden 3D bioprinting approaches relevant to dental pulp regeneration, focusing on bioink composition, cellular components, printing modalities, experimental models, and reported regenerative outcomes. The review followed the Joanna Briggs Institute methodology and was reported according to the PRISMA extension for scoping reviews. Electronic searches were conducted in PubMed, Embase, Web of Science, and Scopus from database inception to December 2025. Following screening of 143 records and assessment of 23 full-text articles, 13 studies met the inclusion criteria. All included studies were preclinical investigations published between 2018 and 2026. Extrusion-based bioprinting was the most frequently used modality, followed by digital light processing systems. Gelatin methacryloyl (GelMA) was the predominant bioink base and was commonly combined with collagen, hyaluronic acid, fibrin, or dentin-derived extracellular matrix components. Human dental pulp stem cells were the most frequently used cell source, often cocultured with endothelial cells to promote vascularization. Most studies evaluated cell viability, printability, and odontogenic differentiation, whereas angiogenic outcomes were less consistently assessed, and neurogenic outcomes were rarely investigated. Overall, cell-laden 3D bioprinted constructs demonstrate promising feasibility for supporting early regenerative processes relevant to dental pulp regeneration. However, substantial heterogeneity in bioink formulations, experimental models, and outcome reporting currently limits cross-study comparison and translational interpretation. Greater standardization of experimental reporting and the use of anatomically relevant models will be essential to advance the clinical translation of bioprinted constructs for regenerative endodontics. Impact Statement: 3D bioprinting enables spatially controlled deposition of cells and biomaterials, providing a promising strategy for engineering biomimetic constructs capable of regenerating the dental pulp–dentin complex. This scoping review synthesizes current preclinical evidence on cell-laden bioprinting approaches for dental pulp regeneration, including bioink formulations, cellular components, printing modalities, and experimental models. By mapping the existing evidence and identifying key gaps in vascularization strategies, neurogenic outcomes, and model relevance, this review highlights critical priorities for future research and provides a framework to guide the development and translational advancement of bioprinted constructs for regenerative endodontic therapies.

Background: Aging and diabetes mellitus are associated with structural and biochemical changes in dentin, including altered collagen organization, dentinal sclerosis, tubule occlusion, mineral changes, and, in some contexts, increased non-enzymatic collagen glycation. These substrate changes may influence the performance and durability of adhesive restorative materials. However, the extent to which bonding outcomes can be directly attributed to advanced glycation end products (AGEs) remains uncertain, as AGE levels are rarely measured in adhesive studies. Methods: This scoping review followed the Joanna Briggs Institute methodology and was reported in accordance with the PRISMA-ScR guidelines. PubMed, Scopus, Web of Science, and Embase databases were searched from inception to December 1, 2025. Eligible studies evaluated bond strength, interfacial morphology, microleakage, mineral content, or remineralization in dentin affected by aging, diabetes, or experimental glycation. Study selection and data charting were independently conducted by two reviewers. Results: Of the 2615 records identified, 16 primary experimental studies met the inclusion criteria, most of which were in vitro investigations using extracted human teeth. Fifteen studies reported bond strength outcomes, and two assessed microleakage. Only four of the included studies directly evaluated diabetic dentin, and these studies generally reported reduced bond strength, particularly in type 1 diabetes. Most of the included studies evaluated age-related dentin, and the findings were heterogeneous, with many contemporary adhesives showing minimal differences between young and aged dentin. None of the included studies directly quantified AGE levels in dentin before adhesive testing. Conclusion: Dentin alterations associated with aging and diabetes may influence adhesive performance; however, the available evidence is heterogeneous and does not allow these effects to be directly attributed to AGE accumulation. Therefore, aging and diabetes should be interpreted as distinct dentin-modifying contexts rather than equivalent AGE-mediated substrates. Further studies incorporating biochemical assessment of dentin, participant-level clinical variables, and standardized durability testing are needed. Scoping review registration: The protocol for this scoping review was registered on the Open Science Framework (OSF) on 16th January 2026 ( https://doi.org/10.17605/OSF.IO/JWA6H ).

Background: Resin-based composites (RBCs) are commonly used in restorative dentistry, but bleaching agents may compromise their mechanical integrity. The effect of in-office bleaching with 25% hydrogen peroxide (HP) on the flexural strength (FS) of contemporary RBCs remains unclear. Materials and methods: An in vitro study was conducted using three resin composites: Beautifil II (giomer), Spectrum (microhybrid), and Omnichroma (universal). Seventy-two bar-shaped specimens (25 × 2 × 2 mm) were allocated into six groups ( n = 12 each). Three groups served as unbleached controls representing giomer, microhybrid, and single-shade universal resin composites stored in distilled water. The other three groups were the corresponding bleaching subgroups, treated with 25% hydrogen peroxide gel activated in three 15-minute light-assisted cycles (total 45 min). Bleaching was performed with 25% HP gel (Philips Zoom) applied in three 15-min cycles with light activation. The FS was measured by three-point bending according to ISO 4049. The data were analyzed using two-way ANOVA and Tukey’s post hoc tests ( p < 0.05). Results: Bleaching with 25% HP had no significant effect on FS across materials ( p = 0.618). The resin composite type significantly influenced the FS ( p < 0.001). Spectrum exhibited higher FS values than Beautifil II and Omnichroma, which were statistically similar. Conclusion: In-office bleaching with 25% HP did not reduce the FS of the tested RBCs. The material composition had a greater impact on FS than bleaching, with the microhybrid resin composite (Spectrum) performing better than the giomer and universal resin composites.

Background: White spot lesions (WSLs) represent the earliest clinical manifestations of enamel demineralization. Resin infiltration (RI) is a minimally invasive method used to mask WSLs for esthetic improvement; however, infiltrated enamel may remain prone to staining and surface degradation. Carbamide peroxide bleaching agents have been reported to reduce enamel microhardness, while the inclusion of remineralizing components such as amorphous calcium phosphate (ACP) may mitigate these effects. Objectives: To compare the microhardness of resin‐infiltrated enamel with artificial WSLs following the application of 22% carbamide peroxide bleaching systems with and without ACP. Methods: Thirty extracted noncarious maxillary premolars were prepared with artificial WSLs and treated with RI. The samples were randomly divided into three groups ( n = 10): Group 1—RI only; Group 2—RI + 22% carbamide peroxide; and Group 3—RI + 22% carbamide peroxide + ACP. Vickers microhardness was measured at baseline (after RI and prior to intervention) and after 7 days. Data were analyzed using paired t ‐tests for within‐group comparisons and one‐way ANOVA with Tukey’s post hoc test for intergroup comparisons. Results: One‐way ANOVA revealed a statistically significant difference in microhardness among the three groups ( p = 0.039). The highest mean microhardness was observed in the group treated with 22% carbamide peroxide + ACP, demonstrating approximately a 10% increase in Vickers hardness compared with the resin‐infiltrated control group. Post hoc Tukey’s test showed a significant difference between the untreated and ACP‐treated groups ( p = 0.031), while other comparisons were not statistically significant. Baseline microhardness values did not differ significantly among groups ( p = 0.882), confirming comparability prior to intervention. Conclusion: Bleaching agents containing 22% carbamide peroxide, particularly when combined with ACP, were associated with higher posttreatment microhardness compared with the RI‐only group.

Objective: To evaluate the antifungal effect of 25% Tea tree oil and compare it to 2% Chlorhexidine and Nystatin against Candida albicans at both the 4th day and 7th day of inoculation to explore potential alternative treatment options for fungal infections in endodontic therapy. Material and Methods: 82 single-canal human mandibular premolar teeth were cleaned, prepared, and inoculated with a C. albicans suspension. After incubating for 4 and 7 days, the teeth were randomly assigned to receive one of four treatments: Nystatin, Chlorhexidine (CHX), Tea tree oil (TTO), or Dimethyl Sulfoxide (DMSO). After treatment, samples were rinsed and dried. Dentine shavings were collected and incubated to observe the growth of C. albicans. The antifungal activity was measured by the number of Candida colony-forming units. Two-way ANOVA followed by post-hoc Tukey's test was applied to compare the CFU growth. Results: TTO exhibited comparable antifungal activity to CHX (p=0.976) and superior antifungal activity compared to Nystatin (p<0.001). Conclusion: 25% Tea tree oil shows antifungal efficacy against C. albicans, comparable to 2% Chlorhexidine, suggesting it could be a viable alternative for endodontic treatments. However, Nystatin demonstrated only limited antifungal effectiveness.

Scaffold systems are fundamental to regenerative endodontics, functioning as structural frameworks and delivery vehicles for bioactive cues essential to tissue regeneration. This review comprehensively examines scaffold types, functions, and translational challenges in endodontic regeneration. Scaffolds are classified into natural, synthetic, and hybrid matrices with unique mechanical and biological profiles. Advances in nanotechnology, 3D and 4D bioprinting, and smart biomaterials have significantly improved scaffold functionality. Smart scaffolds enable the controlled release of growth factors, antimicrobial agents, and gene-functionalized molecules, facilitating angiogenesis, stem cell differentiation, and infection control. Hybrid scaffolds, such as those combining collagen and gelatin methacryloyl (GelMA), provide customized degradation, biocompatibility, and mechanical strength. Innovative systems such as magnetic nanoparticle-triggered release and responsive hydrogels address vascularization and immune modulation limitations. Clinically, platelet-rich fibrin (PRF), concentrated growth factor (CGF), and decellularized extracellular matrix (dECM) have shown success in promoting root development, pulp vitality, and periapical healing. Despite these advances, obstacles remain, including regulatory hurdles, standardization of protocols, and long-term clinical validation. Integrating AI-driven scaffold design, digital twin simulations, and organ-on-chip models holds promise for personalized therapies. Establishing scaffold-based regeneration as a standard clinical approach will require harmonized practices, scalable biomaterial production, and robust clinical outcome assessments.

Background: Hormonal fluctuations across a woman’s life stages can influence systemic and oral health. However, comparative data on salivary characteristics and oral hygiene across different hormonal phases remain limited. This study aimed to evaluate the salivary flow rate, salivary pH, and oral hygiene status among women in the menstruating, mid-cycle (ovulatory phase), pregnant-third trimester, and menopausal phases. Methods: In this cross-sectional study, 80 women ( n =20 per group: mid-cycle (ovulatory phase), menstruating, pregnant-third trimester, menopausal) were examined. Unstimulated salivary flow (mL/5 min) and pH were measured; oral hygiene was assessed with the OHI-S. Outcomes were analyzed by ANCOVAwith age as a covariate. When omnibus effects were significant, Tukey-adjusted pairwise comparisons of estimated marginal means (EMMs) were performed. Effect sizes are reported as partial eta-squared ( η²p ) values; salivary flow is reported as mL/min for interpretability. Results: After adjusting for age, salivary flow differed by group ( F =92.10, p η²p =0.787). The adjusted means (mL/min) were as follows: mid-cycle 0.831, menstruating 0.912, pregnant 0.427, and menopausal 0.460; menstruating and mid-cycle were greater than pregnant and menopausal (all p p =0.980). Salivary pH also differed ( F =16.55, p η²p =0.398): mid-cycle 7.65, menstruating 7.63, pregnant 6.93, menopausal 6.63; cycling groups exceeded pregnant and menopausal (most p p =0.931) or pH ( p =0.843). Oral hygiene categories differed by group (Fisher’s exact p <0.001), with poorer hygiene in pregnant and menopausal women. However, the cross-sectional design precludes causal inference, findings are restricted to third-trimester pregnancies, and unmeasured factors such as oral hygiene, diet, socioeconomic status, and medication use may have influenced outcomes. Conclusions: The study indicates that hormonal phases, particularly third-trimester pregnancy and menopause, are associated with reduced salivary flow, lower pH, and poorer oral hygiene, underscoring the need for stage-specific preventive strategies and collaboration between gynecologists and dental professionals.

In the field of endodontics, the management of complex resorptive lesions demands innovative and precise interventions. This report delineates the comprehensive management of two distinct cases, each presenting unique challenges. The first case involved a 23-year-old male with hypothyroidism, presenting with pain and external cervical resorption with internal communication in his lower left front tooth. The case was diagnosed with pulp necrosis and asymptomatic apical periodontitis. The second case involved a 26-year-old female in good health, dissatisfied with the cosmetic appearance, and experiencing occasional pain from a previously treated upper front tooth with concurrent external apical and internal resorption. It was diagnosed as previously treated, with symptomatic apical periodontitis. These cases were notable for their complexity and the tailored approach to diagnosis and treatment, employing advanced techniques and materials, such as bioceramic materials, for optimal outcomes. The first case was approached through conventional endodontic disinfection, flap reflection, and the meticulous external management of the resorptive defect with bioceramic material, followed by restorative procedures. The second case required retreatment, including wide canal management, apex negotiation, and the establishment of an apical plug with bioceramic material, culminating in backfilling with thermoplasticized gutta-percha and subsequent prosthetic rehabilitation. Remarkably, both cases demonstrated successful healing and patient satisfaction at a 6-month follow-up, with radiographs and photographs evidencing the desired clinical outcomes. This report highlights the necessity of adaptability, precision, and the integration of innovative materials and techniques in endodontic practice to effectively address complex resorptive lesions. It underscores the significance of a comprehensive diagnostic and treatment framework that can guide clinical decision-making and enhance procedural outcomes in similar challenging scenarios. It contributes valuable insights and reinforces the imperative of detailed management in endodontic complexities.

Aim: As an emerging yet underexplored innovation in dentistry, self-adhesive flowable composites (SAFCs) represent a promising and enduring advancement in the dental material technology. Our study aims to evaluate the shear bond strength of two SAFCs and the bonding of conventional flowable composite (CFC) to permanent dentin. Materials and Methods: Thirty-six teeth were embedded in acrylic blocks, with the occlusal third removed to expose the underlying dentin. A cylindrical mold was positioned on the treated dentin surface and filled with the composite resin material to be evaluated. The prepared permanent dentin surfaces were randomly assigned to three groups based on the following application protocols: Group 1: Axo Uni Flow (AXIMACK, India); Group 2: Constic (DMG, Germany); and Group 3: 37% phosphoric acid etchant + Single Bond Universal + Filtek Z350 XT (3M ESPE, USA). The shear bond strength of the prepared specimens was measured by using a universal testing machine. The data were analyzed with Kruskal–Wallis one-way analysis of variance, followed by Dwass–Steel–Critchlow–Fligner pairwise comparisons. Results: Filtek Z350 XT (3M ESPE, USA) demonstrated higher shear bond strength values when compared to Constic (DMG, Germany) and Axo Uni Flow (AXIMACK, India). A significant difference was found between these materials. However, the shear bond strength of the two SAFCs tested did not differ significantly. Conclusion: The investigation’s findings suggest that the SAFCs exhibited inferior shear bond strength compared with CFCs when bonded with permanent dentin.

The use of resin-based dental composites is multiplying through the years due to the increased demand for tooth-colored restorations. The choice of monomers strongly determines the viscosity, reactivity, mechanical property, water sorption and polymerization shrinkage of the composite material. It is desirable for all monomers to be converted into polymers (Degree of Conversion), but this does not occur clinically, resulting in a poor prognosis for restorations as well as an increase in systemic health risks. The release of monomers occurs due to erosion and degradation, as well as the release of leachable species from the restoration. The potential toxicity of free monomers to dental pulp cells is concerning. Free monomers are not only allergens but also have reported cytotoxic and genotoxic effects. Various methods and practices have thus been employed to counter the ill effects of free monomer release from dental composite restorations for better safety and healthy oral cavities.