Tzimas K, et al. Restor Dent Endod. 2018 Aug;43:e38. https://doi.org/10.5395/rde.2018.43.e38

There is a growing shift from the use of conventional pharmaceutical oral care products to the use of herbal extracts and traditional remedies in dental caries prevention. This is attributed to the potential environmental and health implications of contemporary oral products. This comprehensive review aims at the analysis of plant-derived compounds as preventive modalities in dental caries research. It focuses on data collected from 2019 until recently, trying to emphasize current trends in this topic. The research findings suggest that several plant-derived compounds, either aqueous or ethanolic, exhibit notable antibacterial effects against Streptococcus mutans and other bacteria related to dental caries, with some extracts demonstrating an efficacy comparable to that of chlorhexidine. Furthermore, in vivo studies using plant-derived compounds incorporated in food derivatives, such as lollipops, have shown promising results by significantly reducing Streptococcus mutans in high-risk caries children. In vitro studies on plant-derived compounds have revealed bactericidal and bacteriostatic activity against S. mutans, suggesting their potential use as dental caries preventive agents. Medicinal plants, plant-derived phytochemicals, essential oils, and other food compounds have exhibited promising antimicrobial activity against oral pathogens, either by their anti-adhesion activity, the inhibition of extracellular microbial enzymes, or their direct action on microbial species and acid production. However, further research is needed to assess their antimicrobial activity and to evaluate the cytotoxicity and safety profiles of these plant-derived compounds before their widespread clinical use can be recommended.

The continuous need for simplified, minimally invasive restorative procedures with a high precision has led to the advancement of highly filled flowable resin-based materials. These materials present excellent initial outcomes in various clinical applications, including the injection molding technique. Given that several clinical reports present signs of wear and staining, this systematic review aims to investigate the mechanical and optical properties of highly filled flowable composite resins. A comprehensive literature research was conducted to identify relevant studies from the PubMed, the Cochrane Library, and Scopus databases. Data extraction and screening was performed by two independent evaluators. Both in vitro studies and clinical trials were included. A total of thirty-one studies were included in this review. A total of 27 in vitro studies investigated highly filled flowable composite resins independently, or in comparison with conventional composite resins, traditional flowable composites, bulk-fill flowable composites, glass ionomer cements, and compomers. Additionally, four randomized controlled clinical trials (RCTs) compared highly filled flowable composite resins with their conventional counterparts. Highly filled flowable composite resins exhibit adequate optical properties. Despite their significant improvements, their mechanical properties remain inferior to those of medium-viscosity composite resins. These materials demonstrate a favorable initial performance in the injection molding technique. Based on a limited number of RCTs, these materials demonstrate an adequate performance in class I and II restorations; however these findings should be interpreted with caution. The reported drawbacks in laboratory studies may contraindicate their clinical application in extensive cavities, load-bearing areas, and in cases of excessive tooth wear and parafunctional activity. A careful clinical case selection is strongly recommended.

Metabolomic research tends to increase in popularity over the years, leading to the identification of new biomarkers related to specific health disorders. Saliva is one of the most newly introduced and systematically developed biofluids in the human body that can serve as an informative substance in the metabolomic profiling armamentarium. This review aims to analyze the current knowledge regarding the human salivary metabolome, its alterations due to physiological, environmental and external factors, as well as the limitations and drawbacks presented in the most recent research conducted, focusing on pre—analytical and analytical workflows. Furthermore, the use of the saliva metabolomic profile as a promising biomarker for several oral pathologies, such as oral cancer and periodontitis will be investigated.

Hybrid materials are a recent addition in the field of restorative dentistry for computer-aided design/computer-aided manufacturing (CAD/CAM) indirect restorations. The long-term clinical success of modern dental restorative materials is influenced by multiple factors. Among the characteristics affecting the longevity of a restoration, the mechanical properties and physicοchemical interactions are of utmost importance. While numerous researchers constantly evaluate mechanical properties, the biological background of resin-based CAD/CAM biomaterials is scarcely investigated and, therefore, less described in the literature. This review aims to analyze biofilm formation on the surfaces of novel, hybrid, resin-based CAD/CAM materials and evaluate the methodological protocols followed to assess microbial growth. It is demonstrated that the surface structure, the composition and the finishing and polishing procedures on the surface of a dental restorative material influence initial bacterial adhesion; however, most studies focus on in vitro protocols, and in vivo and/or in situ research of microbiomics in CAD/CAM restorative materials is lacking, obstructing an accurate understanding of the bioadhesion phenomenon in the oral cavity.

The continuous need for simplified minimally invasive dental restorations using bio-materials with adequate mechanical, physical, and biological characteristics has led to an evolution in the field of flowable composites. Nanotechnology focuses on advancing highly filled flowable resin-based materials, which may be used in many restorative indications. Since these materials are a novel addition to the toolkit of restorative dentistry, the purpose of this review is to investigate their in vitro characteristics and clinical performance. Highly filled flowable composite resins proved to be a promising dental biomaterial. Considering that these materials show an ideal initial performance in the injection molding technique and in Class I and II cavities but simultaneously present several drawbacks in laboratory studies, caution should be exercised when selecting the applicable cases. Further, in vitro and clinical studies are needed to establish the precise indications and limitations of this type of biomaterials.