The next frontier in antibacterial dental resins: A 20-year journey of innovation and expectations

Early soluble additives effectively reduced bacteria, but they leached out too quickly, weakening the material. Quaternary ammonium compounds (QAMs) addressed this issue by offering long-lasting, surface-active antimicrobial properties. Nanofillers also provide sustained antimicrobial effects at low concentrations but face challenges such as particle clustering, potential toxicity, and uneven dispersion. New antimicrobial strategies like peptides, ionic liquids, and piezoelectric fillers show potential but face challenges such as biocompatibility, biofilm complexity, and limited real-world testing. Advancing these materials will require better preclinical models, cross-disciplinary collaboration, and computational tools to optimize antibacterial function and material strength.