Multiscale Design of Dental Restorative Materials: Mechanistic Foundations, Technological Innovations, and Clinical Translation.

Dental restorative materials remain constrained by clinical unmet needs in biomechanical durability, bioactivity, and long-term tissue integration, despite incremental advances in conventional ceramics and polymers. Addressing these gaps requires functional innovation. Multiscale design strategies bridge atomic-level material engineering with macroscopic clinical performance. This review highlights transformative approaches, including bioinspired architectures (e.g., decellularized extracellular matrix scaffolds) that replicate native oral tissue mechanics while promoting cell-driven remodeling, and smart interfaces (e.g., pH-responsive polymers) for dynamic biofilm suppression. Functional enhancements are achieved via 3D printing for anatomically precise restorations, nanotechnology for crack-resistant ceramics, and surface functionalization (e.g., graphene oxide coatings) to accelerate osseointegration. Emerging paradigms such as 4D-printed shape-memory composites and artificial intelligence (AI)-driven inverse design further exemplify innovation by enabling self-adapting materials and accelerated discovery of bioactive formulations. Critically, barriers are analyzed to clinical translation, including scalable manufacturing of hierarchical structures, mitigating biodegradation in aggressive oral environments, and balancing cost-effectiveness with performance. By integrating mechanistic insights with clinical translation, this work provides a blueprint for next-generation functional dental materials that reconcile laboratory innovation with real-world clinical demands.