Biomaterials for Management of Dental Caries and Periodontal Disease

A special issue of Journal of Functional Biomaterials (ISSN 2079-4983). This special issue belongs to the section "Dental Biomaterials".

Deadline for manuscript submissions: 30 June 2026 | Viewed by 8568

Special Issue Editors


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Guest Editor
ADA Forsyth Institute, Somerville, MA 02143, USA
Interests: biomaterials; cariology; restorative dentistry; translational research

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Guest Editor
Department of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8525, Japan
Interests: periodontal disease; infection control; inflammation control; tissue regeneration control

Special Issue Information

Dear Colleagues,

This Special Issue highlights recent advancements and interdisciplinary innovations in cariology and periodontology—two critical domains in oral health research that address some of the most widespread and persistent dental diseases globally.

According to the World Health Organization’s Global Oral Health Status Report 2022, dental caries in permanent teeth is the most common health condition worldwide, affecting approximately 2.5 billion people. Untreated caries in primary teeth remains a pressing concern in children, with over 514 million cases reported globally. At the same time, severe periodontal diseases affect around 1 billion people and are a major cause of tooth loss in adults, with serious implications for systemic health, including links to diabetes, cardiovascular disease, and adverse pregnancy outcomes.

These statistics underscore the substantial global burden of both dental caries and periodontal disease as noncommunicable, chronic conditions that compromise quality of life, increase healthcare costs, and disproportionately affect underserved populations.

While traditional approaches such as fluoride therapy, mechanical plaque control, and restorative or surgical treatments have played important roles in caries and periodontal management, they often lack long-term bioactivity and fail to address the underlying biological processes of disease progression and tissue regeneration. In response, there has been a growing focus on the development of advanced biomaterials that not only prevent disease but also support tissue repair and regeneration.

In cariology, functional biomaterials exhibit antimicrobial properties that target cariogenic bacteria like Streptococcus mutans, thereby reducing acid production and biofilm formation. Remineralizing agents restore essential minerals to enamel and dentin, reversing early-stage lesions. Cariostatic biomaterials further protect dental tissues by modulating local pH, releasing fluoride or therapeutic ions, and promoting hard tissue regeneration.

In periodontology, biomaterials are increasingly being used to promote periodontal tissue regeneration, including the repair of alveolar bone, periodontal ligament, and cementum. These materials may incorporate growth factors, antimicrobial peptides, or immunomodulatory agents to combat periodontal pathogens, reduce inflammation, and stimulate the regeneration of soft and hard periodontal structures.

This Special Issue brings together pioneering research and translational studies on multifunctional biomaterials that exhibit antimicrobial, remineralizing, and regenerative properties. By bridging innovations in cariology and periodontology, this Special Issue aims to foster interdisciplinary collaboration and contribute to global efforts in reducing the burden of oral diseases through advanced, evidence-based biomaterial science.

Dr. Mohammed Zahedul Islam Nizami
Prof. Dr. Shogo Takashiba
Guest Editors

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Keywords

  • antimicrobial biomaterials
  • bioactive dental materials
  • cariostatic materials
  • dental caries prevention
  • oral microbiome modulation
  • periodontal regeneration
  • remineralizing agents
  • translational oral health research

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Published Papers (4 papers)

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Research

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13 pages, 2777 KB  
Article
Comparative Cytocompatibility and Oxidative Stress Analysis of Green-Synthesized Nano-Silver Fluoride and Silver Diamine Fluoride in Human Gingival Fibroblasts
by Antonia P. Palankalieva, Iva D. Stoykova, Milen I. Georgiev and Ani B. Belcheva
J. Funct. Biomater. 2026, 17(4), 195; https://doi.org/10.3390/jfb17040195 - 17 Apr 2026
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Abstract
Silver diamine fluoride (SDF) is widely used in pediatric dentistry for caries arrest; however, concerns exist regarding its cytotoxicity. Green-synthesized nano-silver fluoride (NSF) is a potential alternative to SDF, offering antimicrobial efficacy with improved biocompatibility. This study aimed to evaluate the in vitro [...] Read more.
Silver diamine fluoride (SDF) is widely used in pediatric dentistry for caries arrest; however, concerns exist regarding its cytotoxicity. Green-synthesized nano-silver fluoride (NSF) is a potential alternative to SDF, offering antimicrobial efficacy with improved biocompatibility. This study aimed to evaluate the in vitro safety profile of green-synthesized NSF with 5% (w/v) fluoride using Camellia sinensis extract and to compare it with 38% SDF + potassium iodide (KI) formulation in human gingival fibroblasts (HGFs). Eluates of NSF and SDF+KI were tested at serial concentrations of 5%, 1%, 0.1%, 0.01% and 0.005%. Cell viability was assessed after 24, 48, and 72 h using the MTT assay. Additionally, the formation of reactive oxygen species (ROS) in HGFs was detected through fluorescence microscopy. Exposure to 5% SDF+KI resulted in almost complete loss of cell viability at all time points, whereas NSF demonstrated significantly higher viability under the same conditions. Lower concentrations of both materials maintained acceptable biocompatibility. ROS analysis revealed increased oxidative stress in response to 5% SDF+KI, while NSF induced significantly lower ROS levels. NSF exhibited superior biocompatibility compared to SDF+KI, supporting its potential as a safer silver-based material for caries management. Further in vitro and in vivo studies are needed to confirm its clinical safety profile. Full article
(This article belongs to the Special Issue Biomaterials for Management of Dental Caries and Periodontal Disease)
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12 pages, 513 KB  
Article
Fluorescence as a Quantitative Indicator of Cariogenic Bacteria During Chemo-Mechanical Caries Excavation with BRIX 3000 in Primary Teeth
by Zornitsa Lazarova, Raina Gergova and Nadezhda Mitova
J. Funct. Biomater. 2025, 16(12), 453; https://doi.org/10.3390/jfb16120453 - 6 Dec 2025
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Abstract
Minimally invasive treatment is increasingly successful in managing carious lesions in primary teeth, owing to the regenerative capacity of the dental pulp and the possibility to influence the pulp–dentin complex. Chemo-mechanical caries excavation (CME) with Brix 3000, a papain-based enzymatic agent, allows selective [...] Read more.
Minimally invasive treatment is increasingly successful in managing carious lesions in primary teeth, owing to the regenerative capacity of the dental pulp and the possibility to influence the pulp–dentin complex. Chemo-mechanical caries excavation (CME) with Brix 3000, a papain-based enzymatic agent, allows selective removal of infected dentin while preserving affected dentin for potential remineralization. Fluorescence-aided caries excavation (FACE) enables visualization of porphyrins produced by cariogenic microorganisms, guiding selective dentin removal. In this study, 42 children aged 4–7 years with ICDAS II code 05–06 lesions in primary molars were treated, and the correlation between fluorescence intensity and cariogenic microbial load was evaluated. CME was performed using Brix 3000, and residual dentin was categorized by fluorescence as red, red with pale-pink areas, pale-pink, or non-fluorescent. Microbiological samples were collected pre- and post-excavation, cultured under standardized laboratory conditions, and quantitatively analyzed. Results showed that higher fluorescence intensity corresponded to increased presence of S. mutans (ρ = 0.945, p < 0.001), while other species were present in lower quantities. CME with Brix 3000 significantly reduced microbial load, and fluorescence reliably indicated areas requiring removal. These findings demonstrate that combining FACE with Brix 3000 allows precise, minimally invasive caries removal in primary teeth, providing an objective method to guide tissue-preserving excavation while effectively controlling cariogenic microorganisms. Full article
(This article belongs to the Special Issue Biomaterials for Management of Dental Caries and Periodontal Disease)
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14 pages, 704 KB  
Article
Comparative Evaluation of Hyaluronic Acid (hyaDENT BG® Gel) and Enamel Matrix Proteins (Emdogain®) in the Regenerative Treatment of Angular Bone Defects Using Xenograft (Bio-Oss Collagen®)—A Clinical Trial
by Velitchka Dosseva-Panova, Hristina Maynalovska, Antoaneta Mlachkova, Ekaterina Tosheva, Ivan Ivanov and Zdravka Pashova-Tasseva
J. Funct. Biomater. 2025, 16(12), 431; https://doi.org/10.3390/jfb16120431 - 24 Nov 2025
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Abstract
Biomolecules have gained attention in recent years for their potential to enhance regenerative periodontal therapy. This study compared hyaluronic acid (HA) and enamel matrix derivative (EMD), each combined with a xenogeneic graft, in adults with periodontitis presenting vertical bone loss with an intrabony [...] Read more.
Biomolecules have gained attention in recent years for their potential to enhance regenerative periodontal therapy. This study compared hyaluronic acid (HA) and enamel matrix derivative (EMD), each combined with a xenogeneic graft, in adults with periodontitis presenting vertical bone loss with an intrabony component ≥3 mm. Seventeen participants contributed 28 defects, assigned in equal numbers to Bio-Oss Collagen® plus HA gel (hyaDENT BG®) or Bio-Oss Collagen® plus EMD (Emdogain®). Outcomes included reduction in probing pocket depth (PPD), gain in clinical attachment level (CAL), and radiographic measures of residual defect and bone fill, assessed at baseline and 6 months after the surgery. Both approaches produced significant within-group improvements in PPD, CAL, and radiographic bone fill (all p = 0.001). Postoperative values and mean changes did not differ significantly between groups (all p > 0.24). Within the limitations of this small, non-randomized study, the findings indicate that HA gel can achieve clinical and radiographic outcomes comparable to EMD when both are used with a xenogeneic scaffold. These results should be considered preliminary, suggesting that HA may represent a practical and biologically compatible alternative to EMD, particularly in cases where cost, availability, or religious considerations limit its use. Confirmation through larger, randomized, and long-term studies is warranted to validate these observations. Full article
(This article belongs to the Special Issue Biomaterials for Management of Dental Caries and Periodontal Disease)
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Review

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25 pages, 913 KB  
Review
Advances in Bioactive Dental Adhesives for Caries Prevention: A State-of-the-Art Review
by Mohammed Zahedul Islam Nizami, Apissada Jindarojanakul, Qiang Ma, Sang J. Lee and Jirun Sun
J. Funct. Biomater. 2025, 16(11), 418; https://doi.org/10.3390/jfb16110418 - 7 Nov 2025
Cited by 8 | Viewed by 5361
Abstract
The long-term success of composite restorations largely depends on the performance of dental adhesives at the adhesive–tooth interface. Despite ongoing improvements, secondary caries remains the leading cause of restoration failure, primarily due to the adhesive layer’s susceptibility to hydrolytic degradation, bacterial invasion, and [...] Read more.
The long-term success of composite restorations largely depends on the performance of dental adhesives at the adhesive–tooth interface. Despite ongoing improvements, secondary caries remains the leading cause of restoration failure, primarily due to the adhesive layer’s susceptibility to hydrolytic degradation, bacterial invasion, and limited biological functionality. This review provides a comprehensive overview of recent advances in bioactive dental adhesives for preventing recurrent caries, focusing on their mechanisms of action, material performance, therapeutic functions, and clinical potential. Bioactive adhesives combine durable bonding with biofunctional benefits, including remineralization, antimicrobial activity, enzymatic inhibition, and support for tissue regeneration. By integrating these properties, they enhance both the durability of the adhesive interface and oral health. Recent strategies include the incorporation of ion-releasing fillers such as calcium phosphate and bioactive glass, antimicrobial monomers such as MDPB and quaternary ammonium methacrylates, enzymatic inhibitors, and hydrolytically stable resin matrices. Together, these components strengthen the adhesive interface and provide biologically active effects to prevent recurrent caries. Although in vitro findings are promising, challenges remain, including limited long-term clinical data, the absence of standardized evaluation protocols, and barriers to clinical translation. Addressing these gaps is essential to ensure predictable clinical outcomes. Bioactive dental adhesives represent a paradigm shift in restorative dentistry, evolving from passive bonding agents to multifunctional therapeutic materials. By combining structural durability with biological protection, they hold significant potential to prevent recurrent caries and improve the long-term success of composite restorations. Full article
(This article belongs to the Special Issue Biomaterials for Management of Dental Caries and Periodontal Disease)
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