do Nascimento Santos João Vitor, Magalhães Gabriela de Alencar Pinto, Costa Leite Juan Vitor, Pacheco Rafael Rocha, Puppin-Rontani Regina Maria, Ferracane Jack L, Lima Renally Bezerra Wanderley
J Am Dent Assoc. 2025 May;156(5):355-373.e2. doi: 10.1016/j.adaj.2025.02.005. Epub 2025 Mar 25.
The authors aimed to establish the scope and types of evidence concerning the bioactivity of materials used in restorative dentistry. The investigation adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews and Joanna Briggs Institute methodologies for scoping reviews and was registered on the Open Science Framework platform.
A systematic search was conducted across PubMed/MEDLINE, Embase, Scopus, and Web of Science databases through May 31, 2024, along with gray literature and manual searching of the list of references in the articles. Inclusion criteria encompassed clinical and laboratory studies exploring the bioactivity of restorative materials, including both temporary and permanent, commercially available, or experimental materials. Studies deviating from manufacturer's suggested applications for the materials were excluded.
The qualitative analysis incorporated 80 studies. There was a predominance of in vitro studies (63), complemented by a smaller number of reviews (11), randomized clinical trials (4), and case reports (2). Among the various types of restorative materials, resin composites and resin cements were investigated most extensively. Additive components commonly used within the studied restorative materials were bioactive glass and hydroxyapatite or nanohydroxyapatite.
Clinically, the benefits of composites purported to be bioactive remain uncertain. This is largely because the scientific evidence for the bioactivity of dental restorative materials comes mainly from in vitro studies, and there is an absence of specific guidelines for the use of these materials. At this stage, using complementary in vitro methods, such as assessing apatite formation, therapeutic ion release, and mineral formation at the dentin-material interface, is recommended to evaluate bioactivity.
作者旨在确定有关牙体修复材料生物活性的证据范围和类型。该调查遵循系统评价和Meta分析扩展的范围综述首选报告项目以及乔安娜·布里格斯研究所的范围综述方法，并在开放科学框架平台上进行了注册。
截至2024年5月31日，对PubMed/MEDLINE、Embase、Scopus和Web of Science数据库进行了系统检索，并检索了灰色文献以及对文章参考文献列表进行人工检索。纳入标准包括探索修复材料生物活性的临床和实验室研究，包括临时和永久性、市售或实验性材料。偏离材料制造商建议应用的研究被排除。
定性分析纳入了80项研究。体外研究占主导地位（63项），辅以较少数量的综述（11项）、随机临床试验（4项）和病例报告（2项）。在各种类型的修复材料中，树脂复合材料和树脂水门汀的研究最为广泛。在所研究的修复材料中常用的添加剂成分是生物活性玻璃和羟基磷灰石或纳米羟基磷灰石。
在临床上，声称具有生物活性复合材料的益处仍不确定。这主要是因为牙科修复材料生物活性的科学证据主要来自体外研究，并且缺乏使用这些材料的具体指南。在现阶段，建议使用补充性体外方法，如评估磷灰石形成、治疗性离子释放以及牙本质-材料界面处的矿物质形成，以评估生物活性。
