Priscila Toninatto Alves de Toledo

Dentin–pulp regeneration has shifted from passive repair toward biologically guided strategies that preserve pulp vitality and actively regulate the healing microenvironment. This narrative review critically discusses biomaterial-driven approaches for dentin tissue engineering and their potential application in vital pulp therapy. Relevant literature was narratively selected according to thematic relevance, methodological contribution, and translational significance, without a formal systematic-review protocol or quantitative study-selection process; no fixed publication-date restriction was imposed, and both seminal and recent studies were considered. The evidence indicates that naturally derived polymeric scaffolds, nanofibrous membranes, injectable and photocrosslinkable hydrogels, microsphere-based delivery systems, and three-dimensional printed scaffolds can combine structural support with mineral signaling, immunomodulation, endogenous cell recruitment, angiogenesis, odontoblast-like differentiation, and controlled bioactive-agent delivery. Cell-homing and multifunctional platforms are particularly relevant for clinical translation because they may support pulp-preserving therapies without exogenous cell transplantation and may be integrated with familiar restorative procedures. However, most evidence remains preclinical and heterogeneous. Future translation requires standardized dentin-based, inflammatory, microbial, and orthotopic models, together with validation of handling, curing, sealing, degradation, safety, and long-term pulp vitality under clinically relevant conditions.

The contemporary management of dentin injuries has progressively shifted from approaches based solely on reparative mineralized barrier formation toward biologically guided strategies that preserve pulp vitality and promote endogenous regeneration. This paradigm change has driven the development of bioactive biomaterials capable of modulating the dentin–pulp microenvironment rather than serving exclusively as passive sealing materials. This review critically discusses recent advances in biomaterial-based approaches for dentin tissue engineering, emphasizing naturally derived polymeric scaffolds, nanofibrous membranes, injectable hydrogels, microsphere-based delivery systems, and three-dimensional (3D)-printed scaffolds. The biological mechanisms by which these platforms regulate inflammation, recruit endogenous progenitor cells, stimulate angiogenesis, direct odontoblast-like differentiation, and promote extracellular matrix deposition are highlighted. Particular attention is given to the sequential development of mineral-functionalized nanofibrous scaffolds, from the selection of calcium hydroxide and nano-hydroxyapatite as bioactive phases to the incorporation of fibronectin and, subsequently, the flavonoids quercetin and hesperetin to combine odontogenic signaling with immunomodulation. Emerging concepts, including immunoinstructive biomaterials, cell-homing strategies, smart hydrogels, and biofabrication technologies, are discussed in the context of their translational potential for vital pulp therapy. Rather than focusing exclusively on recreating the native tubular architecture of dentin, current regenerative strategies increasingly seek to restore pulp homeostasis and establish biological conditions that enable predictable reparative dentinogenesis. Collectively, these advances position biomaterials as active regulators of tissue regeneration and provide a framework for next-generation therapies aimed at preserving pulp vitality and improving the long-term outcomes of dentin regeneration.

Nipple injuries are common and can cause intense pain, leading to early weaning in breastfeeding. This study investigates the efficacy of photobiomodulation therapy (PBM) in reducing pain and promoting the healing of nipple lesions in lactating women. The protocol of this study was registered in PROSPERO and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020). Electronic searches were conducted (PubMed/MEDLINE, Web of Science, Scopus, Embase, Cochrane Library and grey literature) until March-2024. The eligibility criteria were randomized clinical trials (RCTs). Meta-analysis was conducted using R software with the “META” package. The Odds Ratio (OR) effect measurement was calculated, and a fixed-effect model was applied with a confidence interval of 95%. The Cochrane collaboration tool was used to assess the risk of bias, and the GRADE approach was used to assess the quality of evidence. A total of 924 records were screened, and 7 studies meeting the criteria were included in this review. The findings indicated a notable decrease in breastfeeding-related pain, along with expedited healing of nipple injuries and improvement in quality of life among participants receiving PBM compared with control group. In addition, a meta-analysis confirmed less sucking pain for the PBM group OR 0.43 ([95% CI − 0.23 to 0.79]; p = 0.001). Most studies had a low risk of bias, and the certainty of evidence was classified as low. The results suggest that PBM may be a promising therapeutic approach to reduce pain and improve the healing of nipple lesions. However, more robust, and methodologically standardized randomized clinical trials are needed to confirm and elucidate these results.