Recent Progress in Antimicrobial Strategies for Resin-Based Restoratives

Abstract

Repairing tooth defects with dental resin composites is currently the most commonly used method due to their tooth-colored esthetics and photocuring properties. However, the higher than desirable failure rate and moderate service life are the biggest challenges the composites currently face. Secondary caries is one of the most common reasons leading to repair failure. Therefore, many attempts have been carried out on the development of a new generation of antimicrobial and therapeutic dental polymer composite materials to inhibit dental caries and prolong the lifespan of restorations. These new antimicrobial materials can inhibit the formation of biofilms, reduce acid production from bacteria and the occurrence of secondary caries. These results are encouraging and open the doors to future clinical studies on the therapeutic value of antimicrobial dental resin-based restoratives. However, antimicrobial resins still face challenges such as biocompatibility, drug resistance and uncontrolled release of antimicrobial agents. In the future, we should focus on the development of more efficient, durable and smart antimicrobial dental resins. This article focuses on the most recent 5 years of research, reviews the current antimicrobial strategies of composite resins, and introduces representative antimicrobial agents and their antimicrobial mechanisms.

Keywords: antimicrobial; dental materials; dental restorations; polymeric composite.

Figure 1

Examples of strategies for material composition modifications toward the design of antibiofilm resin-based composites. AgNPs: silver nanoparticles; MgO: magnesium oxide; CNC/ZnO: cellulose nanocrystal/zinc oxide; Zn-MSNs: zinc-doped mesoporous silica nanoparticles; m-SiO₂: mesoporous silica; GNR/CHX: Gold nanorods/chlorhexidine; Fe₃O₄: ferroferric oxide; S-PRG: pre-reacted glass-ionomer; SSHZP: silver sodium hydrogen zirconium phosphate; QAC: quaternary ammonium compound; MDPB: 12-methacryloyloxy dodecyl pyridinium bromide; DHMAI: quaternary ammonium dimethyl-hexadecyl-methacryloxyethyl-ammonium iodide; QPEI: quaternary ammonium salt polyethyleneimine; TMQA: tetrafunctional methacrylate quaternary ammonium salt monomer; DMAHDM: quaternary ammonium dimethylaminohexadecyl methacrylate; MPC: 2-methacryloyloxyethyl phosphorylcholine; Fmoc-F5-Phe: Fmoc-pentafluoro-l-phenylalanine-OH; NACP: amorphous calcium phosphate. NAg: nano-silver. Adapted, with permission, from [1,21,22].

Figure 2

The possible antibacterial mechanisms of different antibacterial agents. (A): Schematic representation of antibacterial mechanism of silver nanoparticles (Nag); (B): Schematic representation of antibacterial mechanism of zinc oxide nanoparticles (NZn); (C): Schematic representation of antibacterial mechanism of quaternary ammonium polyethylenimine (QAS-PEI). Adapted, with permission, from [11].

Figure 3

Schematic illustration of the use of contact antimicrobial agents in resin composites. Adapted, with permission, from [69].

Figure 4

Schematic illustration of the use of 2-methacryloyloxyethyl phosphorylcholine (MPC) in resin composites. Adapted, with permission, from [93].