Bioactive and Ion-releasing materials in minimum intervention dentistry: a clinical pathway from prevention to restorative treatment.

INTRODUCTION: This paper examined the clinical applications of "bioactive" dental materials within a framework of minimum intervention dentistry, ranging from non-invasive to invasive procedures for managing carious lesions. Modern approaches to caries management emphasise personalised care, caries risk assessment, and lesion activity evaluation, combined with the strategic use of ion-releasing biomaterials (IRB). These materials, which can release ions such as calcium, phosphate, fluoride and other ions, may support dental remineralization, stabilize collagen, buffer pH, and deter bacterial growth, thus promoting long-term oral health.

DISCUSSION: The Bioactive Dental Concept finds a great ally with the new generation ABRAM (Advanced Bioactive Restorative Adhesive Material) and available materials; it is structured to guide clinicians to select bioactive options when clinically appropriate. Interventions are categorised as non-invasive (home care and professional applications), micro-invasive (sealants, resin infiltration, peptides), and invasive. Diagnostic tools like fluorescence and infrared imaging improve early detection, enabling minimally invasive, targeted treatments. Early lesions are sealed and remineralised; moderate ones need selective excavation and cavity conditioning. Extensive lesions require durable bioactive restorations, with new materials like "alkasite" and dual-cure bioactive composites. Integrating evidence-based dentistry (EBD) principles remains essential, though reliance on strict hierarchies of evidence may limit the adoption of innovative approaches. Practical clinical experience and biological acceptability must also inform decision-making.

CONCLUSION: The article emphasises the need for a balanced approach that combines the rigor of EBD with clinical pragmatism. Even though no restorative material is yet biologically ideal, bioactive and ion-releasing materials significantly improve the management of carious lesions, supporting the aim of preserving natural tooth structures and promoting oral eubiosis.