Forms of protection of the dentin-pulp complex: a literature review
DOI:
https://doi.org/10.33448/rsd-v14i11.50077Keywords:
Dentin–pulp complex, Pulp capping, Pulp therapy.Abstract
Introduction: Dentin and pulp are co-dependent structures that together form the dentin–pulp complex. When this complex is subjected to aggression, such as deep carious lesions or trauma, it becomes necessary to protect these tissues. The aim of this study is to report the types of materials used and the advantages and disadvantages of each substance employed in the protection of the dentin–pulp complex. Methodology:This is a descriptive literature review (Snyder, 2019), qualitative in nature (Pereira et al., 2018), in a study with little systematization and of the narrative bibliographic review type (Rother, 2007). The search platforms used were the Virtual Health Library, Google Scholar, SciELO, and PubMed, and the terms used in the search for works were "dentin-pulp complex," "pulp capping," and "pulp-dentin and protection". Results and Discussion: The most prominent materials are glass ionomer, calcium hydroxide, and MTA due to their biological and mechanical properties. These materials are applied as protective agents for the dentin–pulp complex, liners, or bases for definitive restorations (Bausen et al., 2020). Final Considerations: Based on the information presented, it is evident that there is no material that possesses all the desired characteristics for the protection of the dentin–pulp complex. Therefore, it is important to emphasize that when selecting a material, the dentist should consider the advantages and disadvantages of each substance.
References
Aïem, H., et al. (2020). Selective versus stepwise carious tissue removal for managing deep carious lesions in deciduous teeth. European Archives of Paediatric Dentistry.
Álvarez-Vásquez, J. L., & Castañeda-Alvarado, C. P. (2022). Dental pulp fibroblast: A star cell. Journal of Endodontics, 48(8), 1005–1019.
Araujo, P. M., et al. (2020). Utilização do mineral trióxido agregado como material retrobturador: Relato de caso. Brazilian Journal of Health Review, 3(3), 4461–4472.
Arandi, N. Z. (2023). The classification and selection of adhesive agents: An overview for the general dentist. Clinical, Cosmetic and Investigational Dentistry, 15, 165–180.
Bausen, A. G., et al. (2020). Proteção da vitalidade dentino-pulpar em odontopediatria: Uma revisão de literatura. Revista da Faculdade de Odontologia de Porto Alegre, 113–121.
Bergenholtz, G., et al. (2020). Treatment of deep caries lesions and the exposed pulp. European Endodontic Journal.
Bertasso, A. S., et al. (2023). Advances in vital pulp therapy: Clinical outcomes and future perspectives. Journal of Dentistry, 132, 104595.
Caparroz, I. C., et al. (2025). Comparação de vedamento de dois cimentos biocerâmicos: Um estudo ex vivo. Brazilian Journal of Health Review, 8(5), e82739.
Ciolli Ceccato, V. M., Guimarães Martins, F., Lenarduzzi, A. L., & Rodríguez, P. A. (2024). Tratamiento conservador de la vitalidad pulpar en molar permanente con silicato tricálcico. Revista de la Facultad de Odontología, Universidad de Buenos Aires, 39(93).
Correia, P., et al. (2025). The impact of intracanal medicaments on crown color, pH, and antimicrobial activity: A comparative study. Brazilian Oral Research, 39.
Covaci, A. M., et al. (2025). Tertiary dentin barrier formation: A comparison between the effects of two calcium silicate based materials. PubMed, 51(1), 96–104.
Estrela, C., et al. (2023). Mechanism of action of bioactive endodontic materials. Brazilian Dental Journal, 34, 1–11.
Hamdy, T. M. (2024). Evaluation of compressive strength, microhardness and solubility of zinc-oxide eugenol cement reinforced with E-glass fibers. Oral Health, 24(487).
Hardan, L., et al. (2023). Effect of different application modalities on the bonding performance of adhesive systems to dentin: A systematic review and meta-analysis. Cells, 12(1), 190.
Herbst, S. R., et al. (2025). Effectiveness of calcium hydroxide compared to hydraulic calcium silicate cements for direct pulp capping. International Endodontic Journal.
Islam, R., et al. (2023). Direct pulp capping procedures: Evidence and practice. Japanese Dental Science Review, 59, 48–61.
Kassis, C., et al. (2021). Response of dental pulp capped with calcium-silicate based material, calcium hydroxide and adhesive resin. Brazilian Journal of Oral Sciences, 21.
Kilic, Y., et al. (2025). Comparative analysis of dentinal tubule penetration: Irrigation activation methods and root canal sealers. BMC Oral Health, 25(1), 991.
Kojima, Y., & Sendo, R. (2022). Maintaining tooth vitality with super minimally invasive pulp therapy. Cureus, 14(9), e29712.
Leal, L. A. D., et al. (2025). Proteção pulpar na atualidade: Necessária ou dispensável? Revista Ibero-Americana de Humanidades, Ciências e Educação, 11(5).
Li, B., et al. (2021). Acidic Monetite Complex Paste with bleaching property. International Journal of Nanomedicine, 16, 31–45.
Li, T., et al. (2020). Effects of adhesive systems on residual caries and pulp vitality. Clinical Oral Investigations.
Matoug-Elwerfelli, M., et al. (2022). Vital pulp treatment for traumatised permanent teeth: A systematic review. International Endodontic Journal, 55(6).
Moraes, J. C. S., Oliveira, S. F. S., & Mendonça, I. C. G. (2021). Lesões de cárie profunda: Revisão de literatura. Brazilian Journal of Health Review, 4(6), 27666–27673.
Moskovitz, M., et al. (2021). Zinc oxide zinc sulfate versus zinc oxide eugenol as pulp chamber filling materials. Children, 8(9).
Nazemisalman, B., et al. (2024). The antibacterial properties of reinforced zinc oxide eugenol with nanoclay. Journal of Functional Biomaterials, 15(7).
Okui, T., et al. (2021). Pulpal defense and dentin bridge formation after carious exposure. Journal of Oral Biosciences, 63(4), 321–328.
Omidi, S., et al. (2020). Effect of pulp-capping materials on dental pulp stem cells. Iranian Journal of Basic Medical Sciences, 23(6), 768–775.
Ordinola-Zapata, R., et al. (2022). Present status and future directions of intracanal medicaments. International Endodontic Journal, 55(S3), 613–636.
Pusa, N., et al. (2025). Clinical success of vital pulp therapy: A systematic review and meta-analysis. Journal of Oral Science, 67(3), 107–115.
Rangel, L. S., et al. (2023). Tratamentos conservadores da polpa. Brazilian Journal of Health Review, 6(6), 28021–28031.
Rattanakijkamol, P., Promta, P., Wanachantararak, P., & Leelapornpisid, W. (2025). Effectiveness of novel calcium hydroxide nanoparticles. Journal of Contemporary Dental Practice, 26(3), 265–272.
Reis, M., Gazzoni, A. F., & Conde, A. (2020). Proteção pulpar direta em odontologia. Revista de Ciências da Saúde, 22(1).
Resende, M. E. A., et al. (2024). Solubility and pH of calcium hydroxide lining cements. RGO - Revista Gaúcha de Odontologia, 72.
Rodrigues, G. G., et al. (2025). Capeamento pulpar direto e indireto. Brazilian Journal of Implantology and Health Sciences, 7(7), 654–670.
Schultz, R., et al. (2021). Remoção seletiva de tecido cariado. RFO UPF, 26(1), 106–112.
Schwendicke, F., et al. (2020). Managing carious lesions: Consensus recommendations. British Dental Journal.
Santos, J. M., et al. (2022). Bioactive endodontic materials for vital pulp therapy: A systematic review. Materials, 15(4), 1363.
Shreyas Neelkanthan, Jawdekar, A. M., & Mistry, L. N. (2025). Success of pulp treatments in children. International Journal of Clinical Pediatric Dentistry, 18(4), 473–478.
Soriano, L. L., et al. (2023). Tratamento cirúrgico de perfuração radicular com MTA. Brazilian Journal of Health Review, 6(6), 27301–27312.
Souza, K. K. O., et al. (2022). Tratamento conservador da polpa: Revisão de literatura. Brazilian Journal of Health Review, 5(3), 11912–11919.
Verdugo-Paiva, F., Zambrano-Achig, P., Simancas-Racines, D., & Viteri-García, A. (2020). Selective removal versus complete removal for deep caries. Cochrane Database of Systematic Reviews.
Vieira, F. S., et al. (2022). Diametral tensile strength of glass ionomer cements. RGO - Revista Gaúcha de Odontologia, 70.
Yamamoto, T., et al. (2021). Structural and functional dynamics of the dentin–pulp complex. International Journal of Molecular Sciences, 22(13), 6875.
Zhang, J., et al. (2024). Novel nanocomposite hydrogel for vital pulp therapy. International Journal of Nanomedicine, 19, 5199–5214.
Zhao, W., et al. (2023). Pulpal responses and defense mechanisms to dental caries. Frontiers in Cellular and Infection Microbiology, 13, 1147816.
Zmener, O., & Boetto, A. (2022). Protección pulpar directa y posterior apexogénesis. Revista de la Asociación Odontológica Argentina.
Zou, X., et al. (2024). Consenso de especialistas sobre irrigação e medicação intracanal. International Journal of Oral Science, 16(1), 23.
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research. 104, 333–9.
Pereira, A. S., Shitsuka, D. M., Parreira, F. J. & Shitsuka, R. (2018). Metodologia da Pesquisa Científica. Santa Maria: Editora da UFSM
Rother, E. T. (2007). Revisão sistemática versus revisão narrativa. Acta Paulista de Enfermagem, São Paulo. 20(2), v–vi.
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Copyright (c) 2025 Suzany Ferreira da Silva, Fernanda Kelly Alves do Bonfim, Letícia Rosalie Santos da Silva, Raquel Araújo Pereira, Jeovana Santos de Oliveira, Allícia Emanuelle Ferreira Santos, Rianna Silva Castro Tavares, Ana Belly Lopes da Silva, Camilla Thaís Duarte Brasileiro, Ellen Luize de Oliveira Cardoso

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