title: Methods to evaluate and strategies to improve the biocompatibility of dental materials and operative techniques.
abstract: OBJECTIVE
  The general aim of this article is to describe the state-of-the-art of biocompatibility testing for dental materials, and present new strategies for improving operative dentistry techniques and the biocompatibility of dental materials as they relate to their interaction with the dentin-pulp complex.
  
  
  METHODS
  The literature was reviewed focusing on articles related to biocompatibilty testing, the dentin-pulp complex and new strategies and materials for operative dentistry. For this purpose, the PubMed database as well as 118 articles published in English from 1939 to 2014 were searched. Data concerning types of biological tests and standardization of in vitro and in vivo protocols employed to evaluate the cytotoxicity and biocompatibility of dental materials were also searched from the US Food and Drug Administration (FDA), International Standards Organization (ISO) and American National Standards Institute (ANSI).
  
  
  RESULTS
  While there is an ongoing search for feasible strategies in the molecular approach to direct the repair or regeneration of structures that form the oral tissues, it is necessary for professionals to master the clinical therapies available at present. In turn, these techniques must be applied based on knowledge of the morphological and physiological characteristics of the tissues involved, as well as the physical, mechanical and biologic properties of the biomaterials recommended for each specific situation. Thus, particularly within modern esthetic restorative dentistry, the use of minimally invasive operative techniques associated with the use of dental materials with excellent properties and scientifically proved by means of clinical and laboratory studies must be a routine for dentists. This professional and responsible attitude will certainly result in greater possibility of achieving clinical success, benefiting patients and dentists themselves.
  
  
  CONCLUSIONS
  This article provides a general and critical view of the relations that permeate the interaction between dental materials and the dentin-pulp complex, and establish real possibilities and strategies that favor biocompatibility of the present and new products used in Dentistry, which will certainly benefit clinicians and their patients.
authors.affiliation: Department of Physiology and Pathology, Araraquara School of Dentistry, UNESP - Univ. Estadual Paulista, Araraquara, São Paulo, Brazil. Electronic address: casouzac@foar.unesp.br.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: de Souza Costa
authors.affiliation: Department of Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, UNESP - Univ. Estadual Paulista, Araraquara, São Paulo, Brazil.
authors.forename: Josimeri
authors.initials: J
authors.lastname: Hebling
authors.affiliation: Department of Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, UNESP - Univ. Estadual Paulista, Araraquara, São Paulo, Brazil.
authors.forename: Débora L S
authors.initials: DL
authors.lastname: Scheffel
authors.affiliation: Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, UNESP - Univ. Estadual Paulista, Araraquara, São Paulo, Brazil.
authors.forename: Diana G S
authors.initials: DG
authors.lastname: Soares
authors.affiliation: Department of Physiology and Pathology, Araraquara School of Dentistry, UNESP - Univ. Estadual Paulista, Araraquara, São Paulo, Brazil.
authors.forename: Fernanda G
authors.initials: FG
authors.lastname: Basso
authors.affiliation: Department of Dentistry, Universidade Federal de Brasília - UNB, Brasília, Brazil.
authors.forename: Ana Paula D
authors.initials: AP
authors.lastname: Ribeiro
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D003764:Dental Materials; D003782:Dental Pulp; D003804:Dentin; D006801:Humans; D013515:Surgery, Oral; D014089:Tooth Remineralization
chemical_list: D001672:Biocompatible Materials; D003764:Dental Materials
keywords: Biocompatibility; Biological response; Cytotoxicity; Dental materials; Dental pulp; Dentin