Regenerative endodontics has emerged as a promising and recognized approach for treating necrotic young permanent teeth. Based on advanced tissue engineering strategies, regenerative therapies, such as cell homing and cell-based transplantation, have been extensively investigated to achieve functional regeneration of the injured pulp-dentin complex. Injectable, thermo-responsive, and tailor-made 3D-printed scaffolds that carry antimicrobial, anti-inflammatory, and other signaling cues provide a powerful means of delivering drugs precisely within the narrow, branching anatomy of the root canal. By enhancing antimicrobial decontamination, an essential step in the regenerative process, these biomaterials establish a permissive microenvironment that promotes cellular migration, adhesion, and subsequent differentiation. Therefore, the current narrative review emphasizes emerging strategies and their optimization to enhance regenerative outcomes in immature teeth affected by pulp necrosis and apical periodontitis.