4 - Biocompatibility of biomaterials for dental tissue repair

Abstract

All dentists and dental patients will benefit from the reduced health risks afforded by guiding dentists to select biomaterials demonstrating biocompatibility for dental tissue repair. Most dentists are concerned about the potential toxic effects of restorative dental biomaterials, and many dentists have had patients who refuse to allow amalgam restorations to be used to restore their teeth. The biocompatibility of dental repair biomaterials can vary greatly with the most toxic generally being zinc oxide eugenol (ZOE), and the least toxic being biomaterials formulated for vital pulp therapy, such as tri-calcium silicate cements (mineral trioxide aggregate (MTA)). The other types of biomaterials (glass ionomers, composite resins, adhesives, sealers, and amalgam) are less toxic than ZOE, but still do not demonstrate suitable biocompatibility to be placed in direct contact with vital tissues. During the past decade, MTA has replaced calcium hydroxide as the first choice of biomaterial for placing in contact with a vital pulp. MTA has low toxicity and good sealing properties to prevent microleakage. MTA can also stimulate the release of growth factors, which promotes the healing and repair of vital pulp tissues. Other biomaterials, such as Emdogain for periodontal regeneration, and PepGen P15 for bone augmentation, contain active growth factors to promote tissue regeneration. Successful dental repair materials must lack toxicity, demonstrate biocompatibility, not induce inflammation sensitivity or pain, be physically stable and seal to prevent bacterial microleakage, and promote tissue repair by creating an environment where growth factors can induce stem cells and local cells to heal injured tissues.