Antibacterial Properties and Fluoride Release of Contemporary Bioactive Restorative Materials

Background: Dental caries is a highly prevalent oral disease globally, leading to significant restorative challenges. Bioactive dental materials have emerged as advanced restorative solutions combining mechanical strength, antibacterial properties and ion releasing ability (especially fluoride). These materials, including glass ionomer cements (GICs), resin-modified GICs (RMGIs), high-viscosity GICs (HVGICs), compomers, giomers, alkasite composites, and bioactive composites (ACTIVA), aim to restore teeth while preventing secondary caries. This review explores their chemistry, clinical applications, antibacterial activity, ion release, and anticariogenic potential, highlighting their role in minimally invasive dentistry. Objectives: To evaluate the effectiveness of bioactive restorative materials in secondary caries prevention, to assess the antibacterial activity of these materials against cariogenic bacterial, to compare fluoride and ion release among different restorative materials, and to summarize their mechanical properties and clinical applications. Aim: To provide a comprehensive understanding of the bioactive properties of contemporary restorative materials and their impact on caries management, including antibacterial effect, fluoride release, and restoration longevity. Methods: Literature review of in vitro and clinical studies on bioactive restorative materials. Analysis of material composition, antibacterial activity, fluoride/ion release, and mechanical properties. Comparison of conventional and modified materials (GIC, RMGI, HVGIC, Compomer, Giomer, Alkasite, ACTIVA) based on clinical applications and evidence of anticariogenicity. Review of methods used to assess antibacterial activity (agar diffusion, bioluminescence, time-kill kinetics, co-culture) and fluoride release (spectrophotometry, ion chromatography, mass spectrometry, ion-selective electrodes). Results: GICs: Moderate antibacterial activity, high fluoride release, limited mechanical strength. RMGICs: Moderate antibacterial activity, moderate fluoride release, improved mechanical strength. HVGICs: Strong antibacterial activity, good fluoride release, high mechanical strength. Compomers: Good aesthetics, limited fluoride release, moderate mechanical strength. Giomer: superior aesthetics, minimal antibacterial activity, low fluoride release, moderate mechanical strength. Alkasite composites: Moderate antibacterial activity, moderate fluoride/ion release, high mechanical strength. Modified resin composite: Strong antibacterial effect, bioactive fluoride and ion release, high mechanical strength. Conclusion: Bioactive restorative materials represent a significant advancement in restorative dentistry. They integrate mechanical durability with biological activity, providing antibacterial activity, ion release, and remineralization that contribute to secondary caries prevention. While traditional GICs excel in fluoride release, modern materials like HVGICs, Alkasite composites, and modified resin composite combine aesthetics, bioactivity, and strength. Further clinical research is needed to evaluate their interaction with oral biofilm, long-term effectiveness, and ion release dynamics, to optimize restorative outcomes.