Oregon Health and Science University
Dental caries continues to be a public health issue, especially more evident in underserved populations throughout the world, necessitating the placement of dental fillings. Resin composites and resin-based materials in general are used in the vast majority of direct, chair-side restorations delivered each year. Those restorations have an average life-spam of about 10 years in service, and the degradation of the materials by hydrolysis and enzymatic attack, together with polymerization shrinkage and fracture, have been pointed as the main causes for restoration failure. While reducing polymerization shrinkage and stress and improving mechanical properties are very important milestones, the main goal of composite development for the future is to make them better able to survive in the oral environment. Any new material development must depart from the simple restoration of form paradigm, in which the filling is simply inert/biocompatible. This talk will discuss novel antibiofilm structures, based on a targeted approach specifically against dysbiotic bacteria. Biofilm coalescence can be prevented by using GTF inhibitors, in a non-bactericidal approach. On the tooth substrate side, MMP-inhibiting molecules can improve the stability of the collagen in the hybrid layer. This talk will also discuss the importance of testing the materials in a physiologically relevant environment, mimicking the conditions in the mouth in terms of mechanical loading, bacterial challenge and presence of saliva. Ultimately, the goal of materials development is to achieve durable restorations, capable of adapting to the oral environment and resisting challenges that go beyond mechanical demands. That way, we can prevent the unnecessary loss of additional tooth structure that comes with every re-treatment.
Abstract
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