Advancements and Challenges in Vital Pulp Therapy: Efficacy, Biomaterials, and Long-Term Outcomes

Vital pulp therapy (VPT) represents a transformative approach in endodontic treatment, focusing on the preservation of pulp vitality in teeth affected by caries or trauma. Over recent years, there has been growing interest in the optimization of VPT due to its potential to maintain tooth function, promote reparative processes, and reduce the need for more invasive procedures. Despite substantial advances in techniques and materials, significant challenges remain regarding consistent clinical outcomes, the biocompatibility of novel biomaterials, and the prediction of long-term therapeutic success. Ongoing debates in the field center around the comparative efficacy of traditional versus novel biomaterials, standardized diagnostic protocols, and the long-term prognostic indicators following VPT applications.Emerging studies have explored a range of new-generation biomaterials, such as bioceramic cements and bioactive molecules, that promise enhanced pulp healing and superior sealing capabilities. Systematic reviews and clinical trials have begun to reveal the strengths and drawbacks of these materials in both primary and permanent teeth, yet many aspects of their biological interactions, long-term safety, and performance in complex cases are still unclear. The current evidence base also highlights heterogeneity in study design, outcome measures, and follow-up periods, highlighting the need for more robust, long-term evaluations. Addressing these gaps requires interdisciplinary discourse and a critical appraisal of both laboratory and clinical data, alongside the integration of patient-centric outcomes.This Research Topic aims to advance understanding and stimulate innovation in vital pulp therapy by addressing key clinical challenges, evaluating the efficacy of emerging biomaterials, and improving the documentation of long-term outcomes. The overarching objectives are to identify predictors of clinical success, refine therapeutic protocols, and foster the development of biomaterials that support sustained tooth vitality. Specific questions include: Which factors most influence the long-term success of VPT? How do new biomaterials perform in diverse patient populations and scenarios? What standardized criteria can be developed to harmonize research and clinical practice?The scope of this Research Topic encompasses both experimental and clinical aspects of vital pulp therapy and is limited to studies that directly assess efficacy, materials, and patient outcomes. To gather further insights in this evolving domain, we welcome articles addressing, but not limited to, the following themes:• Comparative effectiveness of traditional and novel biomaterials in VPT• Mechanisms underlying pulp healing and regeneration• Diagnostic and prognostic markers for VPT outcomes• Long-term follow-up studies and patient-reported outcomes• Innovations in clinical protocols and decision-making algorithms• Ethical, regulatory, and translational considerations for new materials• Support of the development of tools for improved clinical diagnosis• Vital pulp therapy against pulpitis Topic editors: YUSUKE TAKAHASHI, Motoki Okamoto, Vasudev Ballal, Rodrigo Rodrigues Amaral, Catalina Mendez de la Espriella Source: https://www.frontiersin.org/research-topics/75528/advancements-and-challenges-in-vital-pulp-therapy-efficacy-biomaterials-and-long-term-outcomes