Biomaterials Journal

http://www.biomatj.com
Online ISSN: 2812-5045

Type of the Paper (Mini-Review)

Bioactive Materials for the Future of Dentistry

Tamer M. Hamdy 1,*

Citation: Tamer M. Hamdy. A New

1
Trend in Dental Materials Is Bioac- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre
tivity. Biomat. J., 4 (1),1 – 4 (2025). (NRC), Giza, Dokki, 12622, Egypt
* Corresponding author e-mail: [email protected]
https://doi.org/10.5281/znodo.582940
8
Abstract: The term bioactivity is becoming more common in the fields of medicine and dentistry.
Received: 7 January 2025 Its positive implications often lead to its use in marketing dental restorative materials. However,
Accepted: 10 January 2025 there is some confusion surrounding the definition of the term, and concerns about its potential
Published: 20 January 2025 overuse have been raised. In response, FDI has decided to publish a Policy Statement regarding the
bioactivity of dental restorative materials to clarify the term and outline some precautions for its
use in advertising. The background information for this Policy Statement was gathered from current
Copyright: © 2022 by the authors. literature, primarily from the PubMed database and various online sources. Bioactive restorative
Submitted for possible open access materials should provide beneficial effects that are local, intended, and non-toxic, without interfer-
publication under the terms and ing with the primary function of the material, which is to replace dental tissue. Three mechanisms
conditions of the Creative Commons of bioactivity for these materials have been identified: purely biological, a combination of biological
Attribution (CC BY) license
and chemical, or strictly chemical. When the term bioactivity appears in advertisements or descrip-
(https://creativecommons.org/license
tions of dental restorative materials, it is essential to provide scientific evidence—whether from in
s/by/4.0/).
vitro or in situ studies, and ideally from clinical trials—that outlines the mechanism of action, the
duration of the effect (particularly for materials that release antibacterial agents), and the absence of
significant adverse biological side effects, such as the development and spread of antimicrobial re-
sistance. Also, it must be proven that the main goal—like fixing the shape and function of damaged
or missing teeth—is not harmed. This should be backed up by data from lab tests and studies on
patients.

Keywords: Bioactive material; dentistry; remineralization.

Teeth were among the first organs to have their function effectively restored using
inert filling materials that are now well-known to the public, such as amalgams, polymeric
resin composites, and gutta-percha. These materials have provided significant benefits to
the health of millions of patients around the globe. In recent decades, there has been
remarkable progress in the field of dental materials. However, dental diseases like caries
and periodontitis remain very common among people of all ages [1].

Many of the practical issues and discomfort linked to dental and periodontal decay
have been significantly reduced due to modern methods of restoring hard and soft dental
tissues. However, the dental filling procedures we have today are still not ideal; even
though amalgams offer long-term stability, they have increasingly fallen out of favor due
to concerns about mercury release, risks to dental practitioners, and challenges with waste
management [2].

The polymeric resin composites that have replaced traditional materials are known
to promote bacterial adherence and biofilm formation [4]. In terms of current endodontic

Biomat. J., 4 (1),1 – 4 (2025)

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procedures, these methods leave the refilled tooth significantly more fragile and
susceptible to fractures compared to natural teeth. Additionally, while dental implants
have become a common solution for complete tooth replacement, they are not without
their issues. The dental implant root is directly anchored to the alveolar bone, which results
in inadequate cushioning against masticatory forces and can lead to long-term problems
such as marginal bone loss and peri-implantitis [3]. So, there’s a clear need for new
biomaterials that can not only provide mechanical support but also integrate biologically
with the restored dental tissues.
These bioactive materials are expected to interact with the body’s cells and the oral
environment to help regenerate natural tissue and prevent future tooth decay [4]. As a
result, bioactive materials are likely to become the foundation of advanced dentistry in the
future. Some interesting studies have been published about improving dental resin
composites and materials used for filling root canals by adding antibacterial properties [5].
These improvements aim to prevent secondary cavities and infections in root canals.
Secondary cavities are a major health issue and are the main reason why many dental
restorations fail. These infections happen because the dental adhesives and resin
composites used today tend to encourage bacteria to stick to and grow on the restored
areas [5]. Additionally, these materials tend to break down over time, causing cracks and
requiring repeated treatments, which can further damage the teeth [10]. Some problems
with dental restoration failure might be solved by adding substances that kill bacteria on
contact, such as quaternary ammonium or tiny particles and tubes made of metal oxides ,
into the resin material.
This would help stop the growth of bacteria that form sticky layers on teeth. These
methods have already been tried in small clinical studies, like one by Melo et al., where a
special compound was mixed with dental resin to create a mouth device that could
effectively reduce harmful bacteria . Another approach involves adding tiny particles of
amorphous calcium phosphate, which slowly release calcium and phosphate over time,
helping to rebuild tooth enamel [6].
In general, the current trend indicates that over the next ten years, there will likely
be fast progress in creating and testing new, improved dental filling materials. This growth
is largely driven by the dental industry's strong interest in developing new products with
better features. Currently, the preferred treatment for severe dental pulp inflammation
(irreversible pulpitis) involves endodontic procedures and sealing root canals with non-
reactive materials like gutta-percha. However, a major issue with modern endodontic
treatments is that the tooth's pulp is completely removed, losing its natural ability to
maintain and mineralize the tooth. Without a functioning pulp that contains cells
(odontoblasts) that produce dentin, the tooth becomes much more likely to crack or
develop further problems [7].
One of the biggest challenges in dentistry today is figuring out how to regrow a
working periodontal ligament after putting in a dental implant. The PDL is a thin band of
strong, flexible tissue full of collagen and blood vessels. It connects the tooth root to the
surrounding jawbone and helps absorb the pressure from chewing. When a tooth is
removed, the empty socket fills with dense bone, which is later used to anchor the implant.
However, because the implant is directly attached to the bone, the bone ends up bearing
more stress than it would with a natural tooth. Over time, this can lead to bone loss around
the implant and increase the risk of infection, known as peri-implantitis [8].
The buildup of dental plaque biofilms and the ongoing inflammation linked to
micro-fractures in bone due to excessive mechanical stress on the implant surface only
speed up this issue. Consequently, there is a pressing need for biomaterials that can
regenerate periodontal ligament-like tissue around dental implants to improve their long-
term stability. The primary challenge with traditional bioscaffolds, such as those made
from collagen or fibrin, is that they often promote mineralization and bone formation on
the implant surface. While these scaffolds are excellent options for repairing periodontal
bone defects, an effective strategy for reconstructing the periodontal ligament should
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ideally involve a biomaterial that resists mineralization. Recently, we explored the

potential of human Decellularized Adipose Tissue in this regard, showing that this
biomaterial has a significantly lower tendency to be mineralized by osteogenic stem cells
compared to other conventional scaffolds like collagen [9].
In the field of implantology, bioactive materials have been utilized as coatings to
enhance the osseointegration of dental implants and improve their overall biological
performance. Dental implants are typically constructed from bioinert materials such as
stainless steel 316L, commercially pure titanium, its alloy Ti-6Al-4V, and cobalt–chromium
alloys. Various techniques can be employed to apply bioactive coatings to the surfaces of
dental implants, including enameling, sol–gel processes, electrophoresis, laser cladding,
and thermal spraying. The first bioactive glass, 45S5 Bioglass, was developed around 50
years ago. Other bioactive coatings include hydroxyapatite, zirconium dioxide, titanium
dioxide, and zinc oxide. The properties of these materials can be further improved by
incorporating active agents for specific purposes. For example, adding silver ions to the
bioactive glass structure can enhance its antibacterial properties [10].
There is a significant increase in research focused on tissue engineering and bioactive
materials for dental applications. Unlike previous generations of dental materials, which
were primarily selected for their inert properties and minimal adverse reactions, the next
generation of dental materials is anticipated to have genuine biological effects on the
surrounding oral and dental tissues, enhancing integration and functionality.
In conclusion, research in dental materials is evolving from a focus on
biocompatibility to an emphasis on bioactivity. Today, the ideal dental material not only
needs to be biocompatible [18], but also should exhibit biomimetic and bioactive
characteristics. Various bioactive materials can be utilized in endodontics, restorative
dentistry, and implantology, with the choice of the right material depending heavily on
the specific application and its properties.

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