Abstract The aim of the study was to investigate the effectiveness of non-invasive and micro-invasive treatments in active enamel carious lesions in high-caries-risk children. Clinical records of children treated in a dental school setting were retrospectively screened for active enamel carious lesions treated non-invasively (topical fluoride applications, oral hygiene instruction, or dietary guidance) or micro-invasively (sealant). The control of active carious lesions was set as the main outcome established by the combination of inactivation and non-progression of the lesions based on Nyvad and ICDAS criteria, respectively. Individual and clinical factors associated with the outcome were analyzed by Poisson regression. The sample consisted of 105 high-caries-risk children with a mean age of 8.3 (± 2.4) years. From a total of 365 active enamel carious lesions, most lesions (84.1%) were active non-cavitated carious lesions (ICDAS scores 1 and 2) and only 15.9% presented localized enamel breakdown (ICDAS score 3). Of these, 72.6% were inactivated and 92.1% did not progress (mean time of 6.5 ± 4.1 months). The prevalence of controlled carious lesions was higher among children older than 6 years (PR:1.43; 95%CI:1.00–2.03; p = 0.04) and in those with better biofilm control (PR:0.99; 95%CI: 0.98–0.99; p = 0.03). Non-operative approaches are effective for controlling active enamel carious lesions. The majority of active enamel carious lesions became inactive and did not progress after treatment. Caries control was associated with older children and better biofilm control.

ABSTRACT Objective: To compare the pulp vitality of deciduous molars before and after selective caries removal (SCR) or nonselective caries removal to hard dentin (NSCR) over one year, using oxygen saturation percentage (%SaO2). Material and Methods: Deciduous molars with deep occlusal/proximal-occlusal caries lesions were randomized to SCR (n=22) or NSCR groups (n=22). After the caries removal, the teeth were protected with calcium hydroxide cement and restored with composite resin (Filtek Z250). The pulp condition diagnosis was evaluated at baseline, immediately after caries removal, and follow-up (7 days, 1-, 6- and 12-months) by %SaO2. Pulp exposure and pulp necrosis were primary outcomes, and %SaO2 was secondary. Results: Intraoperative pulp exposure occurred in four teeth of the NSCR group (18.2%) and one tooth of the SCR group (4.5%) (p>0.05). Two cases of pulp necrosis occurred in the NSCR group (10%). No difference in %SaO2 pulp was observed in the inter-and intragroup comparison over time (p>0.05). Conclusion: Advantageously, the %SaO2 minimizes preoperatory pulp vitality diagnosis subjectivity before SCR/ NSCR treatments. Furthermore, the pilot study results suggest the pulp response of deciduous molars, when evaluated by clinical, radiographic, and pulp %SaO2 seems not to differ between teeth treated with SCR or NSCR.

Abstract This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12–9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31–10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09–1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11–1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00–1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC.

Resumo Nas últimas duas décadas, observou-se um interesse crescente nos estudos de hipomineralização molar-incisivo (HMI). Os defeitos hipomineralizados podem ter várias consequências, como hipersensibilidade, aumento do acúmulo de placa dentária e, consequentemente, maior risco de cárie. Este estudo transversal teve como objetivo investigar a prevalência de HMI e sua associação com cárie dentária em escolares de um município do sul do Brasil. Uma amostra aleatória de alunos por conglomerado foi selecionada. Os exames clínicos foram realizados para coletar informações sobre HMI (seguindo os critérios da European Academy of Pediatric Dentistry), cárie dentária (usando o índice DMF-T) e gengivite. Variáveis socioeconômicas, demográficas e comportamentais foram coletadas por meio de um questionário padronizado respondido pelos pais / responsáveis pelas crianças. Razões de prevalência (RP) foram estimadas por meio de análise de regressão de Poisson com variância robusta por meio de abordagem hierárquica (p <0,05). Um total de 513 escolares foram incluídos no estudo. A prevalência de MIH e cárie foi de 19,7% e 31,6%, respectivamente. A média de idade foi de 11,6 (± 1,9) anos. A cárie dentária foi mais prevalente em crianças com HMI (RP 1,39; IC 95% 1,05 - 1,85). Crianças mais velhas e crianças cujas famílias estavam matriculadas em programas de transferência condicional de renda (RP 1,97 IC95% 1,47 - 2,64), e crianças que não tinham a mãe ou o pai como chefe da família (RP 1,56 IC95% 1,06 - 2,30) apresentaram maior prevalência de cárie dentária. Nossos resultados sugerem que crianças com HMI são mais propensas a ter cárie dentária.

Abstract The last couple of decades has seen an increasing interest in molar-incisor hypomineralization (MIH) studies. Hypomineralized defects can have several consequences such as hypersensitivity, increased dental plaque accumulation, and consequently higher caries risk. This cross-sectional study aimed to investigate the prevalence of MIH and its association with dental caries in schoolchildren from a city in southern Brazil. A random cluster sample of schoolchildren was selected. Clinical examinations were carried out to collect information on MIH (following the European Academy of Pediatric Dentistry criteria), dental caries (using the DMF-T index) and gingivitis. Socioeconomic, demographic and behavior variables were collected using a standardized questionnaire answered by the children’s parents/caregivers. Prevalence ratios (PR) were estimated using Poisson regression analysis with robust variance through a hierarchical approach (p<0.05). A total of 513 schoolchildren were included in the study. MIH and caries prevalence was 19.7% and 31.6%, respectively. The mean age was 11.6 (+1.9) years. Dental caries was more prevalent in children with MIH (PR 1.39; 95% CI 1.05 - 1.85). Older children and children whose families were enrolled in conditional cash transference programs (PR 1.97 95% CI 1.47 - 2.64), and children who did not have their mother or father as the head of the family (PR 1.56 95% CI 1.06 - 2.30) presented a higher prevalence of dental caries. Our findings suggest that children with MIH are more likely to have dental caries.

ABSTRACT Objective: To investigate the influence de two instruments for evaluation of cariogenic foods consumption by schoolchildren. Material and Methods: The convenience sample comprised of 30 active-caries children (7-10 years old) attended in a public dental clinic and their mothers, who have not received dietary orientation before study. A trained evaluator administered the Previous Day Food Questionnaire (PDFQ) to children and other examiner applied the 24-hour dietary recall with mothers. Internal consistency between PDFQ and 24-hour dietary recall regarding frequency of sugar intake was calculated using intraclass correlation coefficient. Bivariate analyses (Mann-Whitney test) were performed to investigate the factors associated with frequency of sugar intake when using both instruments (α=0.05). Results: A moderate correlation (ICC = 0.51; 95%CI: -0.04-0.77; p=0.03) was found between instruments. Mean frequency of sugar intake reported by mothers and children was 3.5 (± 1.8) and 3.7 (± 1.5) times a day, respectively. When using the PDFQ, the frequency of cariogenic foods consumption varied depending on frequency of toothbrushing, i.e., children that had higher frequency of sugar intake brushed their teeth at least two times a day (p=0.016). Conclusion: Previous Day Food Questionnaire applied with schoolchildren could substitute the mothers' reports of cariogenic foods consumption when dietary interventions for controlling dental caries are necessary. If doubts remain regarding the children's response, mothers should be consulted.

ABSTRACT Objective: To compare the root canal preparation of primary teeth with reciprocating and rotary NiTi instruments. Material and Methods: Electronic databases (PubMed/MEDLINE, Web of Science, TRIP, Lilacs, Embase, and Scopus) were systematically searched until October 2020. In vitro studies comparing the cleaning ability, debris extrusion, file deformation, or working time of rotary and reciprocating NiTi instruments in primary teeth were evaluated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Meta-analyses were conducted using a random-effects model to calculate pooled mean differences between reciprocating and rotary NiTi instruments considering the outcomes: working time (minutes) and debris extrusion (milligrams). Statistical analyses were performed using RevMan 5.3 at a significance level of 5%. Results: From 4,417 potentially relevant studies, 10 were included in the systematic review, and 8 considered in the meta-analyses. There was no significant difference between reciprocating and rotary NiTi instruments considering debris extrusion [3 data sets; effect size: -0.11 (-0.25-0.04); p=0.15] and working time [6 data sets; effect size: -0.37 (-0.98-0.24); p=0.24]. The heterogeneity found was moderate to high. The risk of bias was low in most studies (50.0% of all items across studies). Conclusion: There is no scientific evidence showing superiority of reciprocating or rotary NiTi instruments used for root canal preparation in primary teeth.

Abstract Dentifrices containing different active agents may be helpful to allow rehardening and to increase the resistance of the eroded surface to further acids or mechanical impacts. This study aimed to compare the effects of conventional (sodium fluoride [NaF]) and stannous fluoride (SnF2)-containing dentifrices on reducing erosive tooth wear (ETW). The PubMed/MEDLINE, Scopus, LILACS, BBO, EMBASE, TRIP electronic databases, and grey literature were searched until January 2021 to retrieve relevant in vitro and in situ studies related to research question. There were no restrictions on publication year or language. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. ETW data were pooled to calculate and compare both dentifrices (overall analysis) and in vitro and in situ studies separately (subgroup analysis). Statistical analyses were performed using RevMan5.3 with a random effects model. Of 820 potentially eligible studies, 101 were selected for full-text analysis, and 8 were included in the systematic review and meta-analysis. There was a significant difference between SnF2-containing dentifrices and NaF dentifrices only for in vitro studies (p=0.04), showing a higher effect of the SnF2-containing dentifrices against the erosion/abrasion (effect size: -6.80 95%CI: -13.42; -0.19). Most in vitro and in situ studies had high and low risk of bias, respectively. In vitro literature suggests that the ETW reduction is greater when using SnF2-containing dentifrices instead NaF-containing dentifrices. However, the evidence level is insufficient for definitive conclusions. Clinical trials are necessary for a better understanding of the effect of these compounds on ETW.

Abstract This in vitro study aimed to evaluate the effect of a silane-containing universal adhesive used with or without a silane agent on the repair bond strength between aged and new composites. Forty nanohybrid composite resin blocks were stored in distilled water for 14 d and thermo-cycled. Sandpaper ground, etched, and rinsed speciments were randomly assigned into four experimental groups: silane + two-step etch-and-rinse adhesive system, two-step etch-and-rinse adhesive system, silane + silane-containing universal adhesive system, and silane-containing universal adhesive system. Blocks were repaired using the same composite. After 24 h of water storage, the blocks were sectioned and bonded sticks were submitted to microtensile testing. Ten unaged, non-repaired composite blocks were used as a reference group to evaluate the cohesive strength of the composite. Two-way ANOVA and Tukey’s tests were used to analyze average µTBS. One-way ANOVA and Dunnet post-hoc tests were used to compare the cohesive strength values and bond strength obtained in the repaired groups (α = 0.05). The µTBS values were higher for the silane-containing universal adhesive compared to the two-step etch-and-rinse adhesive system (p = 0.002). Silane application improved the repair bond strength (p = 0.03). The repair bond strength ranged from 39.3 to 65.8% of the cohesive strength of the reference group. Using universal silane-containing adhesive improved the repair bond strength of composite resin compared to two-step etch-and-rinse adhesive. However, it still required prior application of a silane agent for best direct composite resin repair outcomes.

Abstract The aim of this study was to investigate the influence of shortening of etching time for dentin on the restoration survival after selective carious tissue removal in primary molars. This two-arm randomized clinical trial included sixty-two subjects (5–8 year-old) and 100 primary molars presenting moderate dentin carious lesions on occlusal surface. The sample was randomly assigned into groups previously to adhesive application (Adper Single Bond 2; 3M ESPE): etching time recommended by manufacturer (15 s) or reduced (7 s). Resin composite (Filtek Bulk Fill Posterior Restorative; 3M ESPE) was inserted in a single increment for all restorations. Restorations were evaluated at 1, 6, 12, and 18 months using FDI criteria. Survival estimates for restorations’ longevity were evaluated with Kaplan-Meier method. Multivariate Cox regression analysis with shared frailty was used to assess the factors associated with failures (p < 0.05). The etching time did not influence the restorations’ survival (HR 0.35 95%CI 0.11–1.12; p = 0.06). Mean estimated time of survival was 17.6 months (95%CI, 17.2–17.9). The survival rates at the 18-month follow-up were 75.7% and 91.4% (AFR: 16.9% and 5.7%) when primary dentin was acid etched for 15 and 7 s, respectively (log-rank p = 0.06). In conclusion, the etching time for dentin did not influence the clinical behavior of adhesives restorations. However, there was a tendency for better clinical outcome when using etching time of 7 s.

Abstract Objective: To compare the teaching of the pulpectomy in primary teeth among graduate and undergraduate Brazilian dental schools. Material and Methods: From August 2015 to July 2016, an 11-question survey was sent to 44 graduate and 207 undergraduate dental schools. Data obtained were summarized using descriptive statistics. Results: The response rate was higher from graduate (56.8%) than undergraduate (41.1%) courses. Pulpectomy was taught by all participating schools. More than 90% of the undergraduate and graduate courses recommend the use of hand instruments for canals debridement, but the widening of root canals was advised in 69.4% of undergraduate and in 84% of graduate schools. Regarding the irrigatings, 1% sodium hypochlorite as a single irrigating solution was the most taught for both biopulpectomy and necropulpectomy. The iodoform-based Guedes-Pinto paste as the single indication was the preferred root canal filling material in undergraduate schools (30.6%), while the zinc oxide-thickened calcium hydroxide paste as the single option was the most recommended in graduate courses (36%). Endodontic hand file associated with lentulo drill for filling root canals was recommended by most courses. Overall, biopulpectomy was performed in one session, while necropulpectomy led two sessions. Periapical radiograph for diagnosis and final obturation was the most adopted conduct by undergraduate (68.2%) and graduate (72%) schools. Gutta-percha and glass ionomer cement were preferred materials to seal the entrance of the pulp chamber. Conclusion: There was variability in the techniques and materials taught to perform pulpectomy in primary teeth among Brazilian graduate and undergraduate dental schools. Calcium hydroxide paste has been used in similar proportion to iodoform-based paste.

Abstract Objective: To investigate the longevity of endodontic treatments and the survival of endodontic re-treatments performed in primary teeth. Material and Methods: The sample included endodontic treatments and re-treatments conducted in anterior and posterior primary teeth without sedation or general anesthesia among children attending a university dental service. Information collected retrospectively from clinical records was used for analyzing data. The Kaplan-Meier estimator test was used to analyze the longevity and survival of endodontic treatment and re-treatments, respectively. Results: A total of 73 patients with endodontic therapy in primary teeth were included in the study, and 116 teeth were analyzed. After one year, the longevity of endodontic treatments performed on primary teeth was 65.74% with an annual failure rate (AFR) of 34.2%. From 47 endodontic treatment failures, 14 teeth (29.8%) were endodontically re-treated. When the endodontic re-treatment was considered as survival, the longevity of treatments reached 68.06% with 31.9% of AFR after one year of follow-up. There was a significant increase in functional tooth retention in those patients that received an endodontic re-treatment (p<0.001). Retreatment provided an additional mean survival time of 8.3 months. Conclusion: Endodontic treatments performed in primary teeth presented a limited longevity. Endodontic re-treatment is a more conservative alternative for endodontically treated primary teeth that have failed and significantly increase tooth retention.

Resumo Embora o tratamento endodôntico seja amplamente recomendado para polpa dentária comprometida, não há informações sobre os fatores associados ás falhas nos dentes decíduos. O objetivo do trabalho foi avaliar a sobrevida e os fatores associados à falha de pulpectomias realizadas em dentes decíduos por estudantes de odontologia. A amostra foi constituída por pacientes atendidos em um Serviço Odontológico Universitário e necessitaram de tratamento endodôntico em dentes decíduos. O estudo investigou variáveis relacionadas ao tratamento e fatores do paciente potencialmente associados à falha do tratamento. A sobrevivência das pulpectomias foi analisada pelas curvas de Kaplan-Meier seguido do teste de log-rank (p<0,05). A análise incluiu 81 pulpectomias realizadas em 62 crianças (5,6 ± 1,5 anos). A sobrevida atingiu 62,9% em até 12 meses de seguimento. A maioria das falhas ocorreu nos primeiros 3 meses (p<0,001). Os dentes com lesões cariosas no início do tratamento apresentaram mais falhas do que aqueles com restaurações ou história de trauma (p = 0,002). A sobrevida de dentes endodonticamente tratados restaurados com compósito foi maior do que os preenchidos com cimento de ionômero de vidro (p = 0,006). Pulpectomias realizadas em duas ou mais sessões apresentaram mais falhas (p = 0,028). Os pacientes com gengivite apresentaram mais falhas no tratamento endodôntico (p = 0,022). As falhas do tratamento do canal radicular em dentes decíduos foram mais propensas a ocorrer em um curto período de tempo e quando o tratamento foi realizado em dentes com lesões cariosas. O uso de compósito em vez de cimento de ionômero de vidro aumentou a sobrevivência pulpectomias. Sessões repetidas para o tratamento endodôntico e a falta de hábitos de higiene bucal tiveram um efeito negativo sobre os resultados.

Abstract Although endodontic treatment is widely recommended for compromised dental pulp, there is no information regarding the factors associated with failures in primary teeth. The aim of this study was to evaluate the survival and factors associated with failure of pulpectomies performed in primary teeth by dental students. The sample comprised patients treated at a University Dental Service and required endodontic treatment in primary teeth. The study investigated treatment-related variables and patient factors potentially associated with treatment failure. Pulpectomy survival was analyzed by Kaplan-Meier estimator followed by log-rank test (p<0.05). The analysis included 81 pulpectomies performed in 62 children (5.6±1.5 years). The survival reached 62.9% up to 12 months follow-up. Most failures occurred in the first 3 months (p<0.001). Teeth with carious lesions at the start of treatment presented more failures than those with restorations or history of trauma (p=0.002). The survival of endodontically treated teeth restored with composite was higher than the ones filled with GIC (p=0.006). Pulpectomy performed in two or more sessions resulted in more failures (p=0.028). Patients presenting gingivitis had more failures in the endodontic treatment (p=0.022). The failures of root canal treatment in primary teeth were more prone to occur in a short time and when the treatment was performed in teeth presenting carious lesions. The use of composite instead of GIC increased the survival of pulpectomies. Repeated sessions for endodontic treatment and lack of oral hygiene habits had a negative effect on the results.

O objetivo desse estudo foi avaliar a influência do tamanho dos poros de um scaffold à base de poli ácido láctico (PLLA) sobre a proliferação e diferenciação de células tronco da polpa dental (dental pulp stem cells - DPSC). Os scaffolds foram preparados dentro da câmara pulpar de discos de terceiros molares (1 mm), utilizando sal como porógeno (150-250 µm ou 251-450 µm). DPSC (1x105 células) foram semeadas nos scaffolds com diferentes tamanhos de poros e cultivadas em placas de 24 poços. A proliferação celular foi avaliada utilizando WST-1 após 3-21 dias. Além disso, RT-PCR foi utilizado para avaliar a diferenciação odontoblástica das DPSC utilizando marcadores da diferenciação odontoblástica (DSPP, DMP-1 e MEPE). RNA obtido de odontoblastos humanos foi utilizado como controle. A taxa de proliferação celular foi semelhante nos dois scaffolds avaliados, exceto no 14° dia, no qual as células cultivadas nos scaffolds com os maiores poros apresentaram uma maior taxa de proliferação (p<0,05). Após 21 dias, as DSPC cultivadas em ambos scaffolds avaliados foram capazes de expressar os marcadores odontoblásticos DMP-1, DSPP e MEPE. Em resumo, ambos scaffolds avaliados nesse estudo permitiram a proliferação e diferenciação odontoblástica das DPSC.

The aim of this study was to evaluate the influence of the poly-L-lactic acid (PLLA)-based scaffold's pore size on the proliferation and differentiation of dental pulp stem cells (DPSCs). The scaffolds were prepared in pulp chambers of 1-mm-thick tooth slices from third molars using salt crystals (150-250 µm or 251-450 µm) as porogen. DPSC (1x105 cells) were seeded in the scaffolds with different pore sizes, and cultured in 24-well plates. The cell proliferation was evaluated using the WST-1 assay after 3-21 days. Furthermore, RT-PCR was used to assess the differentiation of the DPSCs into odontoblasts, using markers of odontoblastic differentiation (DSPP, DSP-1 and MEPE). RNA from human odontoblasts was used as control. Cell proliferation rate was similar in both scaffolds except at the 14th day period, in which the cells seeded in the scaffolds with larger pores showed higher proliferation (p<0.05). After 21 days DPSCs seeded in both evaluated scaffolds were able of expressing odontoblastic markers DMP-1, DSPP and MEPE. In summary, both scaffolds tested in this study allowed the proliferation and differentiation of DPSCs into odontoblast-like cells.

The aim of this paper was to assess the epidemiology of traumatic dental injury (TDI) in preschool children and its relation to socioeconomic and clinical factors. This study was carried out in Santa Maria, Brazil, during National Children's Vaccination Day, and 441 children aged 12 to 59 months were included. Data about socioeconomic status were collected through a semi-structured questionnaire administered to parents. Calibrated examiners evaluated the prevalence of TDI, overjet, and lip coverage. Data were analyzed with a Poisson regression model (PR; 95% confidence intervals). The TDI prevalence was 31.7%. The maxillary central incisors were the most frequently traumatized teeth. The most common TDI was enamel fracture. No association was found between TDI prevalence and the socioeconomic status of children. After adjustments were performed, the eldest children with an overjet > 3 mm were more likely to have TDI than their counterparts. The data indicated a high prevalence of TDI. Only overjet was a strong predictor for TDI, whereas socioeconomic factors were not associated with TDI in this age group.

A polpa dental é um tecido conjuntivo altamente especializado que possui uma restrita capacidade de regeneração, devido à sua disposição anatômica e à natureza pós-mitótica das células odontoblásticas. A remoção total da polpa, seguida da desinfecção do canal radicular e seu preenchimento com material artificial proporciona a perda de uma significante quantidade de dentina deixando como sequela um dente não vital e enfraquecido. Entretanto, a endodontia regenerativa é um campo emergente da engenharia tecidual, que demonstrou resultados promissores utilizando células-tronco associadas à scaffolds e moléculas bioativas. Desta forma, esse artigo revisa os recentes avanços obtidos na regeneração do tecido pulpar baseado nos princípios da engenharia tecidual e fornece aos leitores informações compreensivas sobre os diferentes aspectos envolvidos na engenharia tecidual. Assim, nós especulamos que a combinação ideal de células, scaffolds e moléculas bioativas pode resultar em significantes avanços em outras áreas da pesquisa odontológica. Os dados levantados em nossa revisão demonstraram que estamos em um estágio no qual, o desenvolvimento de tecidos complexos, tais como a polpa dental, não é mais inatingível e que a próxima década será um período extremamente interessante para a pesquisa odontológica.

Dental pulp is a highly specialized mesenchymal tissue that has a limited regeneration capacity due to anatomical arrangement and post-mitotic nature of odontoblastic cells. Entire pulp amputation followed by pulp space disinfection and filling with an artificial material cause loss of a significant amount of dentin leaving as life-lasting sequelae a non-vital and weakened tooth. However, regenerative endodontics is an emerging field of modern tissue engineering that has demonstrated promising results using stem cells associated with scaffolds and responsive molecules. Thereby, this article reviews the most recent endeavors to regenerate pulp tissue based on tissue engineering principles and provides insightful information to readers about the different aspects involved in tissue engineering. Here, we speculate that the search for the ideal combination of cells, scaffolds, and morphogenic factors for dental pulp tissue engineering may be extended over future years and result in significant advances in other areas of dental and craniofacial research. The findings collected in this literature review show that we are now at a stage in which engineering a complex tissue, such as the dental pulp, is no longer an unachievable goal and the next decade will certainly be an exciting time for dental and craniofacial research.