Will Biologics Change Everything?
Daniel Alter, MSc, MDT, CDT
There is tremendous emphasis in the dental laboratory space on 3-dimensional printing technology and 3D printable resins and composites, so it is no wonder that noteworthy innovations are on the horizon within those two areas. What will they mean for the dental laboratory community and how will they impact the dental patient? I believe restorative processes will become simpler and restorative materials will evolve to provide a greater health benefit beyond the restorative function.
There are impressive efforts and resources invested in the realm of bioactive dental resins, which will allow the dental laboratory to fabricate restorations with active biologic agents designed for specific health purposes. A consortium of international scholars recently published an article titled "Bactericidal and Bioactive Dental Composites," offering deep perspective on antimicrobial, remineralizing, and bioactive restorative materials that are needed to develop both a bacteria-free environment and a tight bond with surrounding tissue.1Using these restorative materials helps prevent the spread of secondary caries that sometimes occurs after the restoration is seated, leading to greater longevity and lifetime viability of dental restorations and their underlying tooth structures. These new composites have been microstructurally characterized, and both long- and short-term studies have concluded that the new composites could ultimately prevent restoration failure and advance patients' well-being. This concept is nothing new, since at present there are dental cements with similar biologic agents preventing further decay and tooth sensitivity. Imagine being able to fabricate a crown, inlay, onlay, and oral appliance that will eradicate any potential future caries or further loss of tooth structure associated with the affected tooth, as well as provide health benefits.
Nonetheless, this could only be the very beginning of introducing biologics and the like through dental prosthetics. It is certainly plausible for future dental materials to incorporate elements like vitamins, minerals, and even certain medications specific to the patient's well-being. As these opportunities evolve, there are questions that remain unanswered concerning the longevity of these substances and the processes by which regenerating or replenishing the elements to continue functioning in the patient's well-being and best interest. Might we see a systematic schedule of replacements for dental prosthetics? Or perhaps a means of replenishing the prosthetic with biologic elements, if not a completely new way of implementation and/or contemporary treatment modalities for the dental patient? Will the medical community engage with dental laboratories to provide appliances that will administer biologics and medication? Whatever the answers may be, it is always advantageous for dental laboratory owners and managers to be forward thinking and consider what might be ahead in order to reap the greatest benefits from these opportunities. One thing that is indisputably constant is that we are always moving forward. It is my honor and pleasure to elevate and inspire with knowledge.
1. Chatzistavrou X, Lefkelidou A, Papadopoulou L, et al. Bactericidal and Bioactive Dental Composites. Front. Physiol. February 16, 2018. https://doi.org/10.3389/fphys.2018.00103