The Journey of Endodontic Biomaterials: Navigating Scientific, Clinical, Patient, and Regulatory Demands

Widbiller M, Galler KM, Schmalz G (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Journal of Endodontics Elsevier

DOI: 10.1016/j.joen.2026.08.026

Abstract

Introduction The development of endodontic biomaterials requires balancing scientific performance, clinical practicality, patient expectations, and regulatory requirements. This review synthesizes these perspectives to map current strengths, limitations, and translational pathways for materials used in vital pulp therapy, root repair, and root canal filling, as well as regenerative endodontics. Methods Narrative literature synthesis integrating recent primary studies, systematic reviews, regulatory standards and normative documents, alongside clinical and market observations, to derive a holistic framework for endodontic biomaterials. Results Scientific priorities favor biocompatibility and bioactivity and regenerative potential, whereas clinicians prioritize ease of handling, predictable performance, and cost-effectiveness. Patients primarily value symptom relief, function, and aesthetics. Regulatory frameworks impose safety and quality requirements through biological validation and mechanical testing. Developments over the past decades demonstrate that hydraulic calcium silicate cements have achieved successful clinical translation by reconciling, in particular, biocompatibility with clinical performance. Biomaterials used in regenerative endodontic procedures likewise show promising clinical outcomes; however, histological evidence frequently indicates reparative tissue formation rather than true pulp-dentin complex regeneration. Emerging directions in both fields, including premixed and fast-setting formulations, smart materials or drug-device combinations, and customized scaffolds for endodontic tissue engineering, hold considerable promise but require clinically relevant testing and demonstration of superiority over current state-of-the-art applications. Conclusions Future innovation in endodontic biomaterials will depend on integrating scientific rigor, clinical feasibility, patient demand, and regulatory strategy from early development to ensure safe, adoptable, and clinically meaningful advances in care.

Authors with CRIS profile

Kerstin Martina Galler Lehrstuhl für Zahn-,Mund- und Kieferheilkunde, insbesondere Fächergruppe Zahnerhaltung

Involved external institutions

Universitätsklinikum Regensburg DE Germany (DE)

How to cite

APA:

Widbiller, M., Galler, K.M., & Schmalz, G. (2026). The Journey of Endodontic Biomaterials: Navigating Scientific, Clinical, Patient, and Regulatory Demands. Journal of Endodontics. https://doi.org/10.1016/j.joen.2026.08.026

MLA:

Widbiller, Matthias, Kerstin Martina Galler, and Gottfried Schmalz. "The Journey of Endodontic Biomaterials: Navigating Scientific, Clinical, Patient, and Regulatory Demands." Journal of Endodontics (2026).

BibTeX: Download