Engineered Biomaterials Trigger Remineralization and Antimicrobial Effects for Dental Caries Restoration

Abstract

Dental caries is the most prevalent chronic disease globally, significantly impacting individuals' quality of life. A key reason behind the failure of implanted restorations is their biological inactivity, meaning they are unable to form crosslinks with the surrounding tooth structures, thus making patients susceptible to implant loss and recurrent tooth decay. For the treatment of caries, antibacterial medicine and remineralization are effective means of treating the recurrence of caries. Owing to the rapid progression in the biomaterials field, several biomaterials have been reported to display antimicrobial properties and aid in dentin remineralization. Bioactive materials hold considerable potential in diminishing biofilm accumulation, inhibiting the process of demineralization, enabling dentin remineralization, and combating bacteria related to caries. Bioactive materials, such as fluoride, amorphous calcium phosphate, bioactive glass, collagen, and resin-based materials, have demonstrated their effectiveness in promoting dentin remineralization and exerting antibacterial effects on dental caries. However, the concentration of fluoride needs to be strictly controlled. Although amorphous calcium phosphate can provide the necessary calcium and phosphorus ions for remineralization, it falls short in delivering the mechanical strength required for oral mastication. Resin-based materials also offer different advantages due to the complexity of their design. In this review, we delve into the application of advanced bioactive materials for enhancing dentin remineralization and antibacterial properties. We eagerly anticipate future developments in bioactive materials for the treatment of dental caries.

Keywords: antibacterial; biomaterials; dental caries; dentin remineralization.

Figure 1

(A) Schematic illustration of the PCBAA/ACP nanocomposite with dual antibiofilm and remineralization functions. Evaluation of the effect of the PCBAA/ACP nanocomposite on inhibiting cariogenic bacterial adhesion and biofilm formation on the enamel surface and promoting enamel remineralization and DT occlusion. (B) Schematic demonstration of the in vitro remineralization of enamel and dentin with the PCBAA/ACP nanocomposite. Reproduced with permission from [26].

Figure 2

(A) Schematic illustration of the preparation of PAMAM-peptide@Galardin. (B) Schematic demonstration of the mechanisms of PAMAM-peptide@Galardin for dual collagen stabilization effects and remineralizing effect. (C) Schematic illustration of the dentin repair and dual collagen-protection effects by PAMAM-peptide@Galardin. Reproduced with permission from [30].

Figure 3

(A) Schematic demonstration of the specific mix of BRP and resin matrix and the subsequent in situ remineralization of HA. (B) SEM image of dentin remineralization induced by the three composites (BT, BT/BG, and BT/BRP) after immersion in AS for 30 days (the arrows point to the BAG particles). Reproduced with permission from [42].

Figure 4

(A) Schematic of the lyso-PEG-induced remineralization process in pits and fissures. (B) Schematic diagram of remineralization within the lyso-PEG-coated pits and fissures. (C) QLF images of the second pits and fissures of the mandibular molar. The red circle refers to changes in fluorescence intensity of plaque biofilm adhesion in the pit and fissure areas. Reproduced with permission from [43].