Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, USA.
Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, OR, USA.
J Dent Res. 2020 Sep;99(10):1140-1149. doi: 10.1177/0022034520927690. Epub 2020 Jun 1.
Dental composites are routinely placed as part of tooth restoration procedures. The integrity of the restoration is constantly challenged by the metabolic activities of the oral microbiome. This activity directly contributes to a less-than-desirable half-life for the dental composite formulations currently in use. Therefore, many new antimicrobial dental composites are being developed to counteract the microbial challenge. To ensure that these materials will resist microbiome-derived degradation, the model systems used for testing antimicrobial activities should be relevant to the in vivo environment. Here, we summarize the key steps in oral microbial colonization that should be considered in clinically relevant model systems. Oral microbial colonization is a clearly defined developmental process that starts with the formation of the acquired salivary pellicle on the tooth surface, a conditioned film that provides the critical attachment sites for the initial colonizers. Further development includes the integration of additional species and the formation of a diverse, polymicrobial mature biofilm. Biofilm development is discussed in the context of dental composites, and recent research is highlighted regarding the effect of antimicrobial composites on the composition of the oral microbiome. Future challenges are addressed, including the potential of antimicrobial resistance development and how this could be counteracted by detailed studies of microbiome composition and gene expression on dental composites. Ultimately, progress in this area will require interdisciplinary approaches to effectively mitigate the inevitable challenges that arise as new experimental bioactive composites are evaluated for potential clinical efficacy. Success in this area could have the added benefit of inspiring other fields in medically relevant materials research, since microbial colonization of medical implants and devices is a ubiquitous problem in the field.
牙科复合材料通常作为牙齿修复程序的一部分进行放置。修复体的完整性经常受到口腔微生物组的代谢活动的挑战。这种活动直接导致目前使用的牙科复合材料配方的半衰期不理想。因此，正在开发许多新的抗菌牙科复合材料来对抗微生物的挑战。为了确保这些材料能够抵抗微生物组衍生的降解，用于测试抗菌活性的模型系统应该与体内环境相关。在这里，我们总结了在临床相关模型系统中应考虑的口腔微生物定植的关键步骤。口腔微生物定植是一个明确界定的发育过程，从牙齿表面获得的唾液膜的形成开始，这是为初始定植者提供关键附着部位的条件性薄膜。进一步的发展包括整合其他物种和形成多样化的、多微生物成熟生物膜。生物膜的发展在牙科复合材料的背景下进行了讨论，并强调了抗菌复合材料对口腔微生物组组成的影响的最新研究。未来的挑战包括抗菌耐药性发展的可能性，以及如何通过对牙科复合材料的微生物组组成和基因表达进行详细研究来对抗这种情况。最终，这一领域的进展需要采用跨学科的方法，以有效地减轻在评估新的实验性生物活性复合材料的潜在临床疗效时出现的不可避免的挑战。在这方面取得成功可能会带来额外的好处，即激发医学相关材料研究领域的其他领域，因为微生物在医学植入物和设备上的定植是该领域的一个普遍问题。
