In conservative dentistry, the primary goals are to preserve as much healthy tooth structure as possible, prevent further demineralization, and extend the longevity of restorations. One innovation in dental materials is the application of bioactive materials—materials that are not merely passive “fillers” but can actively interact with the tooth’s biological environment, for example by releasing ions, supporting remineralization, and exerting antibacterial effects.
One study conducted by Alifia Anandiza F, under the supervision of Dr. drg. Tri Endra Untara, M.Kes., Sp.KG(K) and Dr. drg. Wignyo Hadriyanto, M.S., Sp.KG(K), entitled “Peran Bioactive Glass Sebagai Bahan Pengisi Dalam Resin Komposit terhadap Remineralisasi dan Antibakteri”, examined how bioactive glass can enhance the performance of composite restorations.
Bioactive Glass in the Context of Dental Materials
Bioactive glass (BAG) was first introduced by Larry L. Hench and has since been recognized as a bioactive material capable of interacting with body fluids (such as saliva) to release ions (calcium, phosphate, silicate) that support new mineral formation and improve surface bonding of restorations.
In this study, bioactive glass was used as a filler in composite resin. The objective was for the restoration not only to fill carious lesions but also to actively promote remineralization of tooth structures surrounding the restoration, help prevent further damage, and provide antibacterial effects by inhibiting bacterial growth that can cause secondary caries at restoration margins.
The study concluded that the incorporation of bioactive glass into composite resin provides antibacterial properties and promotes remineralization, thereby helping to prevent secondary caries in restorations.
Mechanisms of Action of Bioactive Materials in Dental Restorations
Several mechanisms explain how bioactive materials support conservative dentistry:
- Ion Release (Ca²⁺, PO₄³⁻, Si⁴⁺)
When restorations interact with saliva or oral fluids, bioactive glass releases ions that contribute to the formation of hydroxyapatite or similar minerals around the restoration interface. - Formation of a Surface Mineral Layer
Released ions can form a new mineral layer on the tooth/restoration surface, strengthening the bond and filling potential microleakage gaps. - Antibacterial Effect / Inhibition of Bacterial Colonization
Several studies indicate that bioactive glass can create local conditions unfavorable for bacterial growth (e.g., increased local pH or specific ion concentrations), thereby reducing biofilm formation around restoration margins. PMC+1 - Self-Healing / Micro-Reparative Effect
In cases of mild local demineralization around restorations, ions from bioactive materials can help repair these areas (remineralization) without the need to replace the entire restoration.
Practical Advantages and Challenges
Advantages
- Restorations become more “active” rather than merely passive fillers.
- Lower potential for secondary caries if microgaps develop.
- Extended restoration lifespan and improved surrounding tissue health.
- Adaptability to changes in oral pH.
Challenges and Considerations
- Excessive bioactive filler content may reduce the mechanical strength of composites (trade-off between bioactivity and strength).
- Long-term stability: sustained ion release over time must be verified.
- Compatibility with resin matrices and adhesive bonding systems varies.
- Potential effects on restoration color and esthetics.
Clinical Implications and Future Directions
- New-generation composite materials containing bioactive glass may become preferred restorative options, particularly in areas with a high risk of secondary caries (e.g., margins near the gingiva).
- Combining bioactive materials with nanotechnology or smart fillers may enhance responsiveness to changing oral conditions (e.g., acidic foods or high bacterial load).
- Long-term clinical trials are essential to confirm that bioactive restorations outperform conventional composites in durability.
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Bioactive materials, particularly bioactive glass as a filler in composite resin, play a crucial role in conservative dental restorations. Through ion release, remineralization support, and antibacterial effects, restorations not only repair damage but also strengthen tooth structures at restoration margins. The study “Peran Bioactive Glass Sebagai Bahan Pengisi Dalam Resin Komposit terhadap Remineralisasi dan Antibakteri” demonstrates that the addition of bioactive glass enhances the biological restorative potential of composite materials.
References
ALIFIA ANANDIZA F, Dr. drg. Tri Endra Untara, M.Kes., Sp.KG(K); Dr. drg. Wignyo Hadriyanto, M.S., Sp. KG(K), The Role of Bioactive Glass as a Filler in Resin Composites on Remineralization and Antibacterial Effects, https://etd.repository.ugm.ac.id/penelitian/detail/218755
Author: Rizky B. Hendrawan | Photo: Freepik
