Pulp-Dentin Complex Regeneration Using Lyophilized Human Exfoliated Deciduous Teeth on a CultiSpher® and Fibrinogen-Thrombin Scaffold

Background: Maintenance of dental pulp vitality is a primary goal of modern endodontic practice.A nonvital tooth exhibits compromised physiological function and diminished biomechanical resilience, thereby limiting its longevity within the oral cavity.Despite significant advances in vital pulp therapy and biomaterial development, uncertainties remain regarding the biological efficacy of these materials, their capacity to regenerate the pulp-dentin complex, and the predictability of long-term clinical outcomes.Objectives: Given the clinical significance of maintaining pulp vitality, researchers and clinicians are increasingly adopting tissue engineering strategies to develop alternative biomaterials capable of functionally regenerating pulp-dentin complex while preserving its physiological integrity.These bioengineered approaches aim not only to sustain vitality but also to reconstruct the native biological architecture and restore the inherent regenerative capacity of dental tissues.Methods: This study aimed to evaluate a newly developed bioengineered material for vital pulp therapy (VPT) in mechanically exposed pulp, using direct pulp capping and partial pulpotomy models.The in vivo experiment was performed on 24 sheep teeth (n=24) and was observed for 7, 14, and 28 days.The bioengineered material -Cultigel, consisted of mesenchymal stromal cells from human exfoliated deciduous teeth (SHED) cultured on gelatin microcarriers (CultiSpher®) within a fibrinogen-thrombin gel, while Biodentine™ served as the control.Histological evaluation assessed pulp vitality, inflammatory response, and reparative dentin formation.Results: Histological analysis revealed favorable regenerative outcomes in the experimental teeth, characterized by angiogenesis, inflammation resolution, and the formation of a highly mineralized dentin bridge.Conclusions: Histological evaluation confirmed the efficacy of the bioengineered material applied for vital pulp therapy, highlighting its potential to achieve functional regeneration of the pulp-dentin complex.These results provide a solid foundation for future large-scale studies to optimize the proposed bioengineering strategy and facilitate its translation into clinical practice.