Biomimetic materials and minimally invasive techniques in contemporary prosthodontics: innovative solutions for preserving natural tooth structure

Abstract

Contemporary prosthodontics is shifting from retention-based full-coverage designs to biomimetic, tissue-sparing solutions that prioritize maximal enamel preservation, judicious dentin management, and sustained function and aesthetics. Aim. To synthesize current evidence on biomimetic materials and minimally invasive techniques in prosthodontics and to appraise their clinical reliability. Materials and methods. The review followed PRISMA 2020, with searches in PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and ScienceDirect (2020–2025). A total of 2,186 records were identified; after screening and full-text assessment, 71 publications were included in the synthesis. At the level of adhesive protocols, biomimetic luting relies on universal systems containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP); selective enamel etching improves retention and marginal adaptation compared with pure self-etch, while immediate dentin sealing is associated with higher overall survival of indirect restorations at a comparable level of postoperative comfort. For single-unit indirect restorations, self-adhesive resin cements are non-inferior to conventional resin cements when the substrate is properly conditioned. By materials, lithium disilicate used for partial-coverage restorations shows approximately 94% three-year survival with durable long-term outcomes; resin-matrix CAD/CAM materials provide acceptable mid-term reliability with prudent case selection; for zirconia, combined surface conditioning with phosphate-containing primers is critical. Minimally invasive designs allow restoration of anatomy and, when needed, occlusal vertical dimension without extensive preparation; debonding remains the main risk for adhesive solutions and is typically manageable by rebonding. Biomimetic materials and minimally invasive protocols constitute a predictable, tissue-conserving strategy for prosthodontic rehabilitation; enamel-oriented adhesion, appropriate zirconia surface conditioning, and an end-to-end digital workflow remain pivotal.