Abstract Smart hydrogels have emerged as versatile biomaterials in endodontics due to their extracellular‑matrix–mimetic architecture, injectability, biocompatibility, and ability to provide controlled delivery of therapeutic agents. This review synthesizes contemporary evidence on functionalised hydrogels—including GelMA, hyaluronic acid, fibrin, chitosan‑based systems, self‑assembling peptides, nanogels, and emerging piezoelectric composites—and evaluates their relevance for drug delivery, root canal disinfection, vital pulp therapy, and pulp‑like tissue regeneration. Literature from PubMed, Scopus, Web of Science, and Google Scholar up to January 2025 was examined, with methodological quality appraised using validated tools tailored to study design. Recent in‑vitro and in‑vivo investigations demonstrate that these hydrogels enhance stem cell viability, angiogenesis, and odontogenic differentiation, while stimuli‑responsive platforms (pH, redox, enzyme, thermal, light, and mechanical) enable context‑specific release of antimicrobials and bioactive molecules. Multifunctional hydrogels show particular promise by integrating antimicrobial, regenerative, and mechanobiological functions, although clinical translation remains limited. Current human evidence is largely restricted to fibrin‑derived scaffolds such as PRF and CGF, with engineered smart hydrogels yet to be validated in clinical trials. Persistent challenges include achieving mechanical stability in the dynamic endodontic environment, ensuring standardisation across studies, and establishing regulatory‑ready manufacturing pathways. Overall, smart hydrogels represent a rapidly advancing class of biomaterials with substantial potential to support precision‑guided regenerative endodontic procedures, warranting further high‑quality in‑vivo research and clinical investigations.
Vats et al. (Sat,) studied this question.
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