The Role of Bioceramic-Based Materials in Promoting Odontoblastic Differentiation During Vital Pulp Therapy

Abstract

Vital pulp therapy (VPT) represents a biologically driven approach aimed at preserving the vitality and function of the dental pulp following injury or exposure. Central to the success of this therapy is the promotion of odontoblastic differentiation, which facilitates reparative dentin formation and pulp healing. In recent years, bioceramic-based materials have emerged as promising agents due to their excellent bioactivity, biocompatibility, and sealing ability. This study explores the role of bioceramic materials—such as mineral trioxide aggregate (MTA), Biodentine, and EndoSequence Root Repair Material—in stimulating odontoblastic differentiation during vital pulp therapy. These materials release calcium and silicate ions that enhance the expression of odontogenic markers, including dentin sialophosphoprotein (DSPP), dentin matrix protein-1 (DMP-1), and alkaline phosphatase (ALP), thereby supporting mineralization and dentin bridge formation. Evidence from recent in vitro and in vivo studies indicates that bioceramics outperform traditional agents like calcium hydroxide in achieving predictable pulp healing outcomes. The biological mechanisms underlying their effectiveness involve the activation of signaling pathways such as BMP, Wnt/β-catenin, and TGF-β, which guide stem cell differentiation toward an odontoblastic phenotype. Therefore, bioceramic-based materials play a critical role in advancing regenerative endodontics by combining clinical reliability with biologically favorable responses. Continued research into their molecular mechanisms and long-term clinical performance is essential to further enhance outcomes in vital pulp therapy.