Abstract

The risk of secondary bacterial infections resulting from dental procedures has driven the design of antimicrobial and antifouling dental materials to curb pathogenic microbial growth, biofilm formation and subsequent oral and dental diseases. Studies have investigated approaches based primarily on contact-killing or release-killing materials. These materials are designed for addition into dental resins, adhesives and fillings or as immobilized coatings on tooth surfaces, titanium implants and dental prosthetics. This review discusses the recent developments in the different classes of biomaterials for antimicrobial and antifouling dental applications: polymeric drug-releasing materials, polymeric and metallic nanoparticles, polymeric biocides and antimicrobial peptides. With modifications to improve cytotoxicity and mechanical properties, contact-killing and anti-adhesion materials show potential for incorporation into dental materials for long-term clinical use as opposed to short-lived antimicrobial release-based coatings. However, extended durations of biocompatibility testing, and adjustment of essential biomaterial features to enhance material longevity in the oral cavity require further investigations to confirm suitability and safety of these materials in the clinical setting. The continuous exposure of dental restorative and regenerative materials to pathogenic microbes necessitates the implementation of antimicrobial and antifouling materials to either replace antibiotics or improve its rational use, especially in the day and age of the ever-increasing problem of antimicrobial resistance.

Highlights

  • According to the World Health Organization (WHO), oral diseases affect nearly 3.5 billion people worldwide [1]

  • Antimicrobial and antifouling dental materials offer a promising role in the prevention of secondary caries, demineralization processes and implant failure occurring from biofilm formation on dental tissues and the dental materials utilized [12]

  • This paper provides an overview of the emerging trends and developments in antimicrobial and antifouling biomaterials for various dental restorative, reconstructive and replacement strategies

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Summary

Introduction

According to the World Health Organization (WHO), oral diseases affect nearly 3.5 billion people worldwide [1]. It has been realized that restorative dental materials capable of bacterial growth inhibition and prevention of microleakage (between the tooth-material interface) is needed to prevent recurring infections, recurrent caries and failure of dental restorative procedures [8,9] Such antimicrobial and antifouling materials either release components which kill microbes upon contact or interrupt and prevent microbial attachment and biofilm formation, respectively. Antimicrobial and antifouling dental materials offer a promising role in the prevention of secondary caries, demineralization processes and implant failure occurring from biofilm formation on dental tissues and the dental materials utilized [12] Transition to these materials may further ascribe to simpler daily maintenance of oral hygiene and longer wear resistance of dental materials. The types of microbial susceptibility and the challenges associated with restorative, prosthetic, endodontic and regenerative materials are expressed

Microbial Susceptibility in Dental Materials
Schematic
Dental Luting Cements
Dental Adhesives and Direct Restorative Materials
Prosthetic Materials and Dental Implants
Endodontic and Dental-Filling Materials
Regenerative Materials
Drug-Releasing Antimicrobial Dental Coatings and Resins
Chlorhexidine-Releasing Systems
Antibiotic-Releasing Systems
Antimicrobial
Polymeric Nanoparticles for Drug Delivery and Immunomodulation
Antimicrobial and Antifouling Polymers
Antimicrobial Quaternary Ammonium Compounds
Antifouling Zwitterionic Polymers
Antimicrobial Peptides
Synthetic AMPs for Dental Applications
Confocal laser scanning
AMP Release-Based Strategies
AMP Immobilisation and Conjugation Strategies
Synthetic Mimics of AMPs as Antimicrobial Polymers
Findings
Conclusions and Future Considerations
Full Text
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