Abstract
Dental adhesives are essential in modern restorative dentistry and are constantly evolving. However, challenges like secondary caries from bacterial infiltration at the adhesive-tooth interface persist. While synthetic antibacterial agents in adhesives show promise, safety concerns have shifted interest toward natural options that are biocompatible, sustainable, and effective. Therefore, this study evaluated whether natural antibacterial compounds in dental adhesives can provide effective antimicrobial activity without compromising their integrity. This systematic review followed PRISMA 2020 statement guidelines. Four databases were screened, PubMed, Scopus, EMBASE, and Web of Science, without language or publication date restrictions until July 2024. The selection criteria were in vitro studies in which natural antimicrobial substances were incorporated into dental adhesives and the resulting composites were tested for their antibacterial and physicochemical properties. A quality assessment was conducted on the selected studies. Most of the studies reviewed reported significant antibacterial activity while retaining the adhesive's integrity, generally achieved with lower concentrations of the natural agents. Higher concentrations increase the antimicrobial effectiveness but negatively impact the adhesive's properties. This review highlights the promising role of natural antibacterial compounds in enhancing the functionality of dental adhesives while also pointing to the need for continued research to address current challenges.