Transforming Pediatric Dentistry with Chitosan Gel: Current Evidence and Emerging Trends-A Scoping Review.

Chitosan, a hydrogel derived from chitin via deacetylation, exhibits antimicrobial, bioadhesive, and regenerative properties, making it a promising biomaterial in pediatric dentistry. Despite extensive research, a comprehensive review of its preventive, restorative, and regenerative applications in children is lacking. This review consolidates current evidence on the mechanisms, clinical uses, and future potential of chitosan-based interventions in pediatric dental care. The search identified a broad spectrum of evidence encompassing preventive, restorative, and endodontic uses of chitosan. Chitosan-based mouthwashes, varnishes, and remineralizing agents demonstrated significant reductions antimicrobial and remineralizing effects, primarily in in vitro studies and limited clinical trials. Incorporating chitosan into cements, adhesives, and resins improved fluoride release, durability, and antibacterial activity without compromising mechanical strength as demonstrated in lab-based studies. In pulp therapy, chitosan nanoparticles enhanced intracanal medicaments, supported hemostasis in pulpotomy, and promoted odontogenic differentiation in regenerative procedures. Although current in vitro and early clinical data are encouraging and present chitosan as a promising biomaterial in the field of pediatric dentistry, large, well-designed trials and standardized formulations are essential to validate long-term safety, and enable consistent integration of chitosan gel-based materials into routine pediatric dental care.