Recent Advances in Antibacterial Dental Adhesives

Background: Bonded restorations have transformed modern dentistry by enabling minimally invasive, esthetic, and durable tooth restorations. However, the long-term effectiveness of dental adhesives is challenged by the complex nature of dentin bonding, hydrolytic and enzymatic degradation, and bacterial infiltration at the adhesive interface, which contribute to restoration failure and secondary caries. Objectives: This review aims to summarize recent advances in antibacterial dental adhesives, focusing on the incorporation of bioactive and nanostructured additives—particularly chitosan and graphene-oxide—to enhance bond durability, mechanical properties, and antibacterial performance. Methods: A comprehensive analysis of contemporary literature was conducted, evaluating the mechanisms of adhesive degradation, the challenges of dentin bonding, and the efficacy of various additives. The review synthesizes findings regarding the chemical, mechanical, and biological effects of incorporating chitosan and graphene-oxide into dental adhesives, as well as the impact of nanoparticles and solvent systems on adhesive performance. Conclusion: Recent advances in antibacterial dental adhesives, particularly through the incorporation of chitosan and graphene-oxide, have significantly improved the durability, mechanical strength, and antibacterial properties of dental restorations. These bioactive and nanostructured additives address key challenges in dentin bonding, such as hydrolytic and enzymatic degradation and bacterial infiltration, thereby enhancing restoration longevity. However, limitations remain regarding optimal additive concentrations, potential effects on esthetics, viscosity, and polymerization, as well as the need for more strong clinical validation. Ongoing research is essential to optimize formulations and confirm long-term clinical benefits.