Biyoaktivite Kavramı ve Güncel Restoratif Materyaller
Özet
Restoratif diş hekimliğinde biyoaktivite kavramı ve güncel biyoaktif materyaller giderek daha fazla önem kazanmaktadır. Biyoaktif materyaller, yalnızca biyouyumlu olmanın ötesinde, çevre dokularla etkileşime girerek remineralizasyonu destekleyen, antibakteriyel etki gösterebilen ve pulpa-dentin kompleksini koruyabilen sistemler olarak tanımlanmaktadır. Ancak literatürde biyoaktif, biyouyumlu ve biyointeraktif kavramlarının sıklıkla karıştırıldığı ve bu nedenle terminolojik bir netliğe ihtiyaç olduğu vurgulanmaktadır. Biyoaktivite mekanizmaları temel olarak iyon salınımı, pH tamponlama, remineralizasyon ve antibakteriyel etki üzerinden gerçekleşmektedir. Özellikle kalsiyum silikat bazlı materyaller, yüksek pH oluşturma ve dentin köprüsü oluşumunu destekleme özellikleri nedeniyle gerçek biyoaktiviteye en yakın sistemler olarak kabul edilmektedir. Cam iyonomer simanlar, S-PRG içerikli materyaller, biyoaktif kompozitler ve alkasitler ise farklı düzeylerde biyolojik etkileşim gösterebilmektedir. Bununla birlikte günümüzde biyoaktif olarak tanıtılan birçok materyalin, gerçek biyolojik yanıt oluşturmaktan ziyade sınırlı veya biyointeraktif düzeyde etki gösterdiği düşünülmektedir. Klinik başarı açısından yalnızca biyoaktivite değil, mekanik dayanım ve uzun dönem stabilite de kritik öneme sahiptir. Sonuç olarak, gelecekte geliştirilecek restoratif materyallerin biyolojik ve mekanik özellikleri dengeli şekilde bir araya getiren sistemler olması beklenmektedir.si ve uzun dönem izlem temel basamaklar olarak kabul edilmektedir.
The concept of bioactivity and the development of contemporary bioactive materials have gained increasing importance in restorative dentistry. Bioactive materials are defined as systems that go beyond mere biocompatibility by interacting with surrounding tissues, promoting remineralization, exhibiting antibacterial effects, and supporting the pulp–dentin complex. However, it has been emphasized that the terms “bioactive,” “biocompatible,” and “biointeractive” are often used interchangeably in the literature, highlighting the need for clearer terminology. The mechanisms of bioactivity are primarily based on ion release, pH buffering, remineralization, and antibacterial effects. Calcium silicate–based materials, in particular, are considered to be among the closest systems to true bioactivity due to their ability to create an alkaline environment and promote dentin bridge formation. Glass ionomer cements, S-PRG- containing materials, bioactive composites, and alkasites, on the other hand, demonstrate biological interactions at varying levels. Nevertheless, many materials currently marketed as bioactive are thought to exhibit limited or predominantly biointeractive effects rather than inducing a true biological response. From a clinical perspective, not only bioactivity but also mechanical properties and long-term stability are critical for success. Therefore, future restorative materials are expected to integrate biological functionality with optimal mechanical performance in a balanced manner.
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Spagnuolo G. Bioactive dental materials: The current status. Materials. 2022;15(6): 2016. https://doi.org/10.3390/ma15062016
Sauro S, Carvalho RM, Ferracane J. The rise of advanced bioactive restorative materials: Are they redefining operative dentistry?. Dental Materials. 2025;41(11): 1411–1429. https://doi.org/10.1016/j.dental.2025.08.003
Melo MAS, Garcia IM, Mokeem L, et al. Developing bioactive dental resins for restorative dentistry. Journal of dental research. 2023;102(11): 1180–1190. https://doi.org/10.1177/00220345231182357
Attik N, Richert R, Garoushi S. Biomechanics, bioactive and biomimetic philosophy in restorative dentistry ̶ Quo vadis?. Journal of Dentistry. 2024;148: 105036. https://doi.org/10.1016/j.jdent.2024.105036
Yun J, Burrow MF, Matinlinna JP, et al. Design of multi-functional bio-safe dental resin composites with mineralization and anti-biofilm properties. Journal of Functional Biomaterials. 2024;15(5): 120. https://doi.org/10.3390/jfb15050120
Hench LL, Thompson I. Twenty-first century challenges for biomaterials. Journal of Royal Society Interface. 2010;7(4):S379-391.
https://doi.org/10.1098/rsif.2010.0151.focus
Hussein N, Refai DAE, Alian GA. Remineralization potential and mechanical evaluation of a bioactive glass containing composite (An ex vivo study). Open Access Macedonian Journal of Medical Sciences. 2021;9: 179. https://doi.org/10.3889/oamjms.2021.6725
Alhusainy A. Bioactive dental composites and bonding agents. Journal of Pharmaceutical Negative Results, 2023;7735. https://doi.org/10.47750/pnr.2022.13.s09.906
Gündüz Bektaş G, Duman Özbilgi Ö, İyibilir AF, et al. The effect of acidic beverages on surface characteristics of the alkasite, bulk-fill, and universal resin composite restorative materials. European Journal of Research in Dentistry.2024;8(3): 130-137.
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Wiriyasatiankun P, Sakoolnamarka R, Thanyasrisung, P. The impact of an alkasite restorative material on the pH of Streptococcus mutans biofilm and dentin remineralization: an in vitro study. BMC Oral Health. 2022;22: 334. https://doi.org/10.1186/s12903-022-02354-4
Oğlakçı B, Arhun N, Tuncer D. Restoratif diş tedavisinde pulpa kaplamaları. Atatürk Üniversitesi Diş hekimliği Fakültesi Dergisi. 2016;14: 94-103
Koutroulis A, Kuehne SA, Cooper PR, et al. The role of calcium ion release on biocompatibility and antimicrobial properties of hydraulic cements. Scientific Reports. 2019;9: 19019. https://doi.org/10.1038/s41598-019-55288-3
Baltacıoğlu E, Demir Dikmen R, Baltacı Yıldız EA. Direkt pulpa kaplaması tedavilerinde kullanılan materyallere güncel bir bakış. BÜSAD. 2022;3(1):127-135.
Özcan M, Garcia LDFR, Volpato CAM. Bioactive materials for direct and indirect restorations: concepts and applications. Frontiers in Dental Medicine. 2021;2: 647267. https://doi.org/10.3389/fdmed.2021.647267
Namba N, Yoshida Y, Nagaoka N, et al. Antibacterial effect of bactericide immobilized in resin matrix. Dental materials. 2009;25(4): 424–430. https://doi.org/10.1016/j.dental.2008.08.012
Mitwalli H, AlSahafi R, Albeshir EG, et al. Novel nano calcium fluoride remineralizing and antibacterial dental composites. Journal of Dentistry. 2021;113: 103789. https://doi.org/10.1016/j.jdent.2021.103789
Tjäderhane L, Nascimento FD, Breschi L, et al. Strategies to prevent hydrolytic degradation of the hybrid layer-A review. Dental Materials. 2013;29(10): 999-1011. doi: 10.1016/j.dental.2013.07.016
Porto ICCM, Lôbo TLGF, Rodrigues RF, et al. Insight into the development of versatile dentin bonding agents to increase the durability of the bonding interface. Frontiers in dental medicine. 2023;4: 1127368. https://doi.org/10.3389/fdmed.2023.1127368
Perdigão J. Current perspectives on dental adhesion: (1) dentin adhesion—not thereyet. Japanese Dental Science Review. 2020;56: 190–207. doi: 10.1016/j.jdsr.2020.08.0041.
Melo MA, Orrego S, Weir MD, et al. Designing multiagent dentalmaterials for enhanced resistance to biofilm damage at the bonded interface. ACS applied materials & interfaces. 2016;8: 11779–87. doi: 10.1021/acsami.6b01923.
Pinto KP, da Silva GR, Ferreira CMA, et al. Success rate of direct pulp capping on permanent teeth using bioactive materials: a systematic review and meta-analysis of randomized clinical trials. Restorative Dentistry & Endodontics. 2024;49(4): e34. https://doi.org/10.5395/rde.2024.49.e34
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