## 4 Dental Biomaterials for VPT
### Restorative Dentistry and Pulp Preservation  
As restorative dentistry has progressed, materials with enhanced biological and mechanical properties have emerged. Although traditional glass ionomer cements (GICs) and resin-modified glass ionomer cements (RMGICs) are not primary agents for direct pulp capping, their contributions to pulp vitality preservation through secondary sealing effects are increasingly recognized. GICs are appreciated for their fluoride release, chemical adhesion to tooth structure, and biocompatibility. However, they are limited in high-stress applications due to low fracture toughness and poor damage tolerance limitation supported by recent studies exploring their atomic and vibrational structure during setting [50]. RMGICs were introduced to improve mechanical resilience by combining resin components with GICs, but they still face challenges such as insufficient sealing in deep cavities and risks of bacterial microleakage, which can lead to pulp inflammation.  
\begin{table}
\begin{tabular}{l l l l l l} \hline
**Biomaterial** & **Brand Name** & **Composition** & **Mechanism of Action** & **Advantages** & **Limitations** \\ \hline Calcium Hydroxide [47] & Dycal-Densply & Ca(OH2) in paste or powder form & Releases Ca2\({}^{n}\) and OH\({}^{-}\) & Biocompatibility promotes & Low mechanical properties and porosity in the newly formed \\  & [47] & & & & \\  & & & & & \\  & & & & & \\  & & & & & \\  & & & & & \\  & & & & & \\  & & & & & \\ \hline Mineral Trioxide & PreRoot MTA-Densply & Tricalcium silicate, dicalcium & Promotes dentin bridge & High biocompatibility, & Prolonged setting time \\ Aggregate (MTA) & MTA Angluus–Angulus & silicate, tricalcium aluminate & formation, seals pulp exposure, and releases Ca2\({}^{n}\) & durable seal & Lower compressible strength and hardness than TreatCal LC \\  & NeoMTA Plus–Awalon & & & & \\  & & & & & \\  & & & & & \\  & & & & & \\ \hline Biodentine & Biodentine by Septodent & Calcium silicate-based with & Similar to MTA, fast-setting, & Stimulates odontable & Less radiopacity than MTA. \\  & [52,53] & additives (zirotanium oxide, etc.) & forms hydroxyapatite & differentiation [51] & Lower wash-out resistance \\  & & & & & \\  & & & & & \\  & & & & & \\ \hline Endo sequence Root & Endsequence-Brasseler & Calcium phosphate, calcium & Scals pulp exposure, & No mixing required, high & Limited data on long-term \\ Repair Material [54] & & silicate-based & biocompatible, & sealing ability, Easy Handling & effectiveness, and more \\  & & & & & expensive \\ \hline ThereCal LC & Thread-Bisco & Light-curable calcium silicate & Forms a durable layer, & Easy handling & Low biocompatibility and high \\  & [55] & & calcium release & promotes healing & cytotoxicity due to the presence \\  & & & & & of monomers like BioMA, \\  & & & & & \\  & & & & & \\ \end{tabular}
\end{table}
Table 1: An overview of conventional dental biomaterials used in vital pulp therapy.  
These limitations underscore the need for next-generation DPC materials that offer robust sealing, intrinsic antibacterial properties, and superior mechanical characteristics. Furthermore, the long-term success of VPT depends not only on biologically favorable pulp capping agents but also on the definitive coronal restoration. A well-sealed durable restoration is essential to prevent microleakage and maintain the therapeutic effects of pulp preserving interventions. Advances in biomimetic restorative materials may substantially enhance clinical outcomes by providing both bioactivity and mechanical resilience, ultimately supporting pulp vitality and reducing failure rates [56; 57].  
Building on these restorative and material innovations, the following section explores regenerative biomaterials and emerging biotechnologies that further enhance VPT outcomes.