Materiais dentários bioativos: estado da arte e prospecção tecnólogica

Abstract

Bioactive materials are able to promote an induced and programmed physiological response in living tissue, cells or organisms. The dentin-pulp complex has a number of biologically active molecules in its composition, such as transforming growth factor-ß1 (TGF-ß1) and bone morphogenetic protein-7 (BMP-7) that acts in repair and regeneration events of teeth. A better understanding of dentin matrix proteins may allow exploring new treatments with materials for biologically based therapies. Initially, this study aimed to analyze the state of the art and technique of treatments for vital pulp in order to assess the recent advances and future prospects in the sector. A literature search was conducted in papers (PubMed, Lilacs, IBECS, BBO, Web of Science, Scopus, SciELO and The Cochrane Library) and patents databases (Questel Orbit, USPTO, EPO, JPO, the INPI and Patentscope). It was analyzed 799 documents related to materials for dentin-pulp complex protection, which showed that calcium hydroxide cement and mineral trioxide aggregate (MTA) have been the most studied over the years. Recent advances in MTA derived materials (calcium silicate, calcium aluminate, calcium phosphate cements) and bioactive materials containing proteins showed promising results that could improve treatments for vital pulp in the near future. In addition, a systematic review was conducted to evaluate the efficacy of deliver bioactive dentin molecules in vital pulp treatments. A total of 32 animal experiments were included in the analysis. In general, the use of bioactive proteins potentiated tertiary dentin formation in direct and indirect pulp capping, promoting a lower initial inflammatory response. Bioactive materials showed potential use for new therapeutic approaches focused on repair and regeneration processes of dental organ.