Emerging Role of Hydrogels in Endodontics: Current Applications, Regenerative Potential, and Future Perspectives

Abstract

Hydrogels are increasingly important in endodontic research because they combine high water content, tuneable physicochemical behaviour, injectability, biological compatibility and the capacity to deliver antimicrobial or regenerative signals within the complex root canal environment. Their relevance reflects a wider shift in endodontics from purely debridement-and-filling approaches towards biologically informed repair and regeneration of the dentine–pulp complex. This narrative review examines the current applications of hydrogels in endodontics, with emphasis on antimicrobial intracanal medication, injectable regenerative scaffolds, cell-delivery systems, decellularised extracellular-matrix hydrogels, drug-delivery platforms, dentine–pulp complex repair and emerging hydrogel-based obturation concepts. The literature search covered publications since 1 January 2000, while allowing inclusion of older classic studies only when necessary to explain foundational concepts. The principal databases searched were PubMed/MEDLINE, Web of Science Core Collection, Scopus and Google Scholar. Additional searches were performed in Embase, the Cochrane Library, Dentistry & Oral Sciences Source, Europe PMC and SciFinder-n. The review evaluates the regenerative potential of hydrogels in relation to vascularisation, odontogenic differentiation, immune modulation, innervation and cell homing. Hydrogels have shown considerable promise in preclinical studies because they can be formulated to conform to irregular canal anatomy, retain therapeutic molecules, protect encapsulated cells and support tissue-like matrix formation. However, translation into routine endodontic practice remains limited by persistent challenges, including microbial biofilm control, compatibility with irrigation protocols, standardisation of degradation and mechanical behaviour, variability in natural and decellularised matrices, sterilisation, storage, regulatory complexity and the scarcity of long-term human clinical evidence. Future progress is likely to depend on clinically simple but biologically instructive hydrogels that integrate disinfection, tissue guidance, controlled degradation and compatibility with existing endodontic procedures. Hydrogels should therefore be viewed not as a single replacement material, but as a diverse family of adaptable biomaterial systems with the potential to reshape regenerative and minimally invasive endodontics.