Sustainable Restorative Dentistry: Integrating Life Cycle Assessment, Minimally Invasive Dentistry, and Bioactive Material Innovations

Abstract

Sustainability has emerged as a critical priority in healthcare systems due to their substantial contribution to global environmental degradation, with dentistry—particularly restorative dentistry—playing a notable role through intensive material consumption, chemical discharge, energy use, and waste generation. This narrative review synthesizes current evidence on sustainable restorative dentistry by integrating Life Cycle Assessment (LCA), minimally invasive dentistry (MID), and recent advances in bioactive and smart restorative materials. A structured but non-systematic literature review was conducted using major scientific databases, including PubMed, Scopus, and Web of Science, focusing on sustainability, restorative materials, LCA methodologies, and conservative clinical approaches. Evidence from LCA studies demonstrates marked variability in the environmental performance of restorative materials. Dental amalgam exhibits the highest ecological burden due to mercury toxicity and associated environmental risks, leading to its phase-down under the Minamata Convention. Resin-based composites are associated with considerable carbon emissions related to energy-intensive manufacturing processes, polymerization, and packaging waste, whereas glass ionomer cements (GICs) consistently demonstrate lower environmental impacts owing to their water-based composition and favorable life cycle profiles. Minimally invasive strategies, particularly prioritizing repair over complete replacement of restorations, substantially reduce clinical waste, energy consumption, and loss of sound tooth structure while extending restoration longevity. In addition, bioactive and smart materials—including GICs, calcium silicates, and ion-releasing systems—actively promote remineralization, inhibit secondary caries, and support tissue regeneration, thereby aligning clinical performance with sustainability goals. The integration of LCA-informed decision-making, digital workflows, and the 4R framework (Reduce, Reuse, Rethink, Recycle) into clinical practice and dental education fosters a systems-based approach to sustainability. Sustainable restorative dentistry thus represents an ethical, evidence-based paradigm that aligns oral healthcare delivery with environmental responsibility and defines a future-oriented standard for restorative dental practice.