DOI: 10.4103/jioh.jioh_357_25 ISSN: 0976-7428

Exposure to Bisphenols (BPA, BPS, and BPF) and Clinical Outcomes of Posterior Resin Restorations: A Systematic Review

Manisha Kohli, Nireeksha, Sunnanguli Gowrish, Vandana Sadananda
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Abstract

Objective:

Resin-based composites are extensively used for posterior restorations; however, several formulations contain bisphenol-derived monomers that may result in trace bisphenol release during clinical use. The aim of this review was to systematically appraise in vitro and randomized clinical evidence on bisphenol exposure associated with posterior resin restorations and its relationship with mechanical, biological, and clinical outcomes.

Methods:

Electronic searches were performed in PubMed, Scopus, and Web of Science in accordance with Preferred Reporting Items for Systematic Reviews and Meta‑Analyses 2020 guidelines. In vitro studies and randomized clinical trials assessing bisphenol-containing or bisphenol-free posterior resin materials were included. Risk of bias (RoB) was evaluated using a modified checklist for in vitro studies and the Cochrane RoB 2 tool for clinical trials.

Results:

Fourteen studies (11 in vitro and 3 randomized clinical trials) were included. Most in vitro investigations demonstrated moderate RoB, mainly due to limited reporting of blinding and sample size justification. Clinical trials showed low RoB or some concerns. Bisphenol-free materials exhibited mechanical and clinical performance comparable to conventional bisphenol-containing composites.

Conclusion:

Current evidence suggests that bisphenol-free posterior resin materials demonstrate outcomes comparable to traditional composites. Nonetheless, long-term randomized clinical trials directly quantifying patient bisphenol exposure are warranted.

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