Biomimetic Restorative Dentistry on Instagram: Exploratory Analysis of Brazilian PostsABSTRACT
Objective: To analyze Brazilian Instagram posts related to Biomimetic Restorative Dentistry (BRD) and identify their characteristics, communicative intent, and level of technical foundation.
Material and Methods: In this exploratory study, 1,000 posts associated with eight specific BRD-related hashtags were manually collected between December 26 and 28, 2024. After applying the inclusion and exclusion criteria, 84 posts from Brazilian accounts were classified into eight thematic categories. Inferential analyses were performed to assess associations between categorical variables.
Results: Visual content centered on clinical procedures was predominant, with limited technical contextualization. The most frequent category was Clinical Sequence (43%); nevertheless, 38.9% of these posts lacked any technical explanation, only 5.6% included references, and none showed clinical follow-up. Categories with an educational focus (Education for Dentists: 14%; Information for Patients: 13%) were underrepresented and rarely included explicit citations to supporting sources. No statistically significant associations were observed between the assessed categorical variables.
Conclusion: Content related to BRD on Instagram displays a predominantly visual, promotional character focused on clinical practice, with limited technical information, scarce citation of references, and complete absence of clinical follow-up. Although some posts demonstrate educational potential, their impact remains limited. These findings highlight the need to promote more critical, structured, and evidence-based digital communication, especially on platforms with broad professional and social reach, such as Instagram.
Keywords:
Health Education; Dental; Health Communication; Dentistry; Operative; Dental Restoration; Permanent.
Introduction
Biomimetic Restorative Dentistry (BRD), also known as Biomimetic Dentistry, has gained widespread popularity in recent years, attracting practitioners worldwide. Its philosophy is grounded in mimicking the biological principles of nature and thoroughly understanding natural teeth to achieve functional and long-lasting restorations [1]. BRD is also described as the art and science of restoring damaged teeth using materials that replicate the properties of natural teeth, namely their strength, appearance, and function [2]. Moreover, according to certain BRD professors, a biomimetic approach may yield more durable restorations through less invasive procedures, free of postoperative sensitivity, while providing teeth with protection against caries and catastrophic failure [3,4].
Although there are no clear distinctions between the fundamental goals of contemporary Adhesive Dentistry and BRD, the clinical protocols proposed by the latter are often described by practitioners as innovative and more effective [3,4]. However, some of these BRD protocols have recently been analyzed through the lens of Evidence-Based Practice (EBP), revealing a lack of robust scientific support and overreliance on clinical experience and individual judgment rather than on available scientific evidence [5]. In addition, cognitive biases and heuristics have been identified as potential drivers shaping dentists’ perceptions of this philosophy, which may help explain its growth despite limited scientific rigor, particularly through digital platforms [5].
In this context, digital social media has played a prominent role not only in the general dissemination of health-related information but also in the promotion of emerging philosophies such as BRD. Platforms such as Instagram, Facebook, YouTube, and TikTok, as well as others with less reach, allow both professionals and patients to access, share, and consume content in a fast and visually engaging manner [6]. This democratization of information has created new opportunities for health education and promotion, but has also raised significant challenges, such as the spread of unverified content or content based more on personal experiences than on scientific evidence [6-8]. The ease with which certain posts go viral may contribute to the formation of inaccurate or overestimated perceptions of clinical techniques and philosophies, as is the case in BRD [9,10]. Therefore, it is important to critically analyze the type of information being disseminated through these platforms and how it may influence clinical decision-making and the formation of professional and public opinion.
Among the various social media platforms available, Instagram stands out as one of the most influential today, especially because of its visual format, which facilitates the dissemination of images and content related to clinical procedures, aesthetic outcomes, and new trends in dentistry [11,12]. With approximately two billion monthly active users worldwide, Instagram also has significant penetration in Brazil, which ranks among the countries with the highest number of users on the platform [11]. In the field of dentistry, Instagram has become a showcase for professional promotion, dissemination of clinical cases, service marketing, and ongoing education [12], both for students and practitioners. Within this landscape, topics related to BRD have gained considerable visibility, often driven by striking images, personal testimonials, and the promise of superior results. Nevertheless, to date, no studies have systematically examined the content available on Instagram related to this philosophy, representing a significant gap in the literature, especially considering the potential impact of such posts on clinical practice and professional perception.
Therefore, the objective of the present exploratory study was to analyze the content related to Biomimetic Restorative Dentistry in Brazilian posts on Instagram.
Material and Methods
Study Design and Data Collection
This exploratory, cross-sectional, descriptive study used content analysis to characterize Brazilian Instagram posts related to BRD. Posts were manually collected from the Instagram social media website (www.instagram.com) by the researchers CFR and KGS between December 26 and 28, 2024.
Using the platform’s native search tool, hashtags related to BRD were identified based on two criteria: they had to be written in Portuguese (or in forms similar to Portuguese owing to orthographic resemblance to Spanish) and have more than 100 posts. Because of the linguistic proximity between Portuguese and Spanish, particularly regarding accent use, some of the selected hashtags may appear in Spanish, although they are frequently used in Brazilian Portuguese contexts.
To determine the number of posts per hashtag, each term was individually entered into Instagram’s search bar, which automatically displayed an approximate count of associated posts. Only hashtags with more than 100 posts were included. The final selection comprised the following eight hashtags: #biomimetica, #biomimética, #biomimeticadental, #odontologiabiomimetica, #odontologiabiomimética, #odontologíabiomimética, #odontologíabiomimetica, and #odontologiarestauradorabiomimética. Hashtags in English were deliberately excluded to ensure the specificity of the sample to Brazilian content, although some Brazilian professionals may occasionally use English-language hashtags in their posts.
Taking into consideration previous studies that have also analyzed health-related information published on Instagram [13-15], 1,000 posts were defined as the target sample for this study. A proportional stratified sampling method was applied to ensure balanced representation across the selected hashtags. The total number of posts used as the basis for stratification corresponded to the cumulative number of posts associated with the eight selected hashtags at the time of data collection (Table 1). A proportional number of posts was assigned to each subgroup based on the relative weight of each hashtag. Posts were selected manually following the order presented by Instagram’s native search algorithm, which typically prioritizes relevance, user engagement, or recency; therefore, this algorithm-driven selection should be considered non-probabilistic.
Proportional distribution of selected posts by hashtags related to Biomimetic Restorative Dentistry.
The URLs of 1,000 posts selected through stratified sampling were compiled into a Microsoft Excel spreadsheet (Microsoft Corporation, Redmond, WA, USA) for organization and screening, and duplicate entries were removed. Researcher CPH conducted a preliminary analysis of the first 100 posts to define eight thematic categories (“Clinical Sequence”, “Education for Dentists”, “Information for Patients”, “Professional Showcase”, “Before and After”, “Event Promotion”, “Event Documentation”, and “Miscellaneous Dental Content”), establishing operational criteria (covering language style, target audience, degree of technicality, visual focus, and communicative intent) grounded in qualitative content analysis principles and consistent with methodologies applied in previous digital social media studies [16-18]. This categorization framework (Table 2) served as the reference standard for training two researchers (CFR and KGS), who, after receiving detailed instructions, applied the classification to a calibration set. The inter-rater reliability between the two trained raters was assessed on a 200-post calibration set using Cohen’s kappa (κ = 0.70), indicating substantial agreement.
Once calibration was completed, the researchers categorized the entire set of posts according to the established thematic framework. In parallel, they conducted a detailed review of each post to collect both the publication and account information. For each post, the following data were recorded: publication language, username, profile type (dentist, technician, dental store, etc.), account location, verification status (presence of the blue verified badge), and whether the word ‘biomimetic’ (in any language) appeared in the account biography. To ensure the geographic focus of this study, only posts from Brazilian accounts were retained. The primary criterion for determining the account’s location was the “Account based in” field, accessible through the three-dot menu on each Instagram profile. When this information was unavailable or inconclusive, references to Brazilian cities, states, or regions in the biography served as secondary criteria. Posts from accounts that could not be reliably identified as Brazilian were excluded. In cases where doubts or discrepancies persisted, a third researcher (CPH) made the final decision to ensure consensus and consistency in categorization.
For posts classified under “Clinical Sequence”, the presence of a technical explanation was assessed. A technical explanation was defined as any written description, either in the caption or superimposed on the images, that explicitly included diagnostic information or case description, mentioned dental materials or instruments used, detailed specific operative steps, or the sequencing of the procedure, and/or presented a rationale for clinical decision-making. Mentions limited to generic statements, aesthetic evaluations, or emotional expressions (e.g., “beautiful result”, “saving teeth”, or “patient very happy”) were not considered valid. Additionally, for all posts in this category, the presence of bibliographic references or sources of information, clinical follow-up (post-treatment evaluation), and the anatomical region involved (anterior, posterior, or both) were recorded to further characterize the quality and focus of the disseminated content.
In the “Education for Dentists” and “Information for Patients,” the inclusion of a technical explanation defined according to the same criteria established for the “Clinical Sequence” category was a mandatory requirement for classification. Posts within these categories had to provide clear technical content; otherwise, they were reassigned to other non-educational categories, such as “Professional Showcase” or “Before and After.” In addition, it was recorded whether the post mentioned any bibliographic references or other identifiable sources of information.
For the categories “Professional Showcase” and “Before and After,” the anatomical regions depicted in the posts were recorded to identify which areas of the dentition (anterior, posterior, or both) were most frequently represented in these categories. This information was collected as a descriptive variable to provide additional insight into the distribution of clinical focus across the analyzed content.
Data Analysis
All extracted variables were organized in a Microsoft Excel spreadsheet for tabulation and descriptive analyses. Categorical variables, such as thematic category, presence of technical explanation, references or sources of information, clinical follow-up, and anatomical region, were summarized as absolute frequencies and percentages. Bivariate associations between categorical variables were examined using contingency tables. Pearson’s chi-square test was applied when its assumptions were satisfied; otherwise, Fisher’s exact test was used for sparse tables (e.g., low expected cell counts). All analyses were conducted using the open-source statistical software Jamovi version 2.7.13 (Sydney, Australia), adopting a two-sided significance level of α = 0.05.
Results
From the initial 1,000 posts collected on Instagram, 36 duplicate entries were removed, along with 160 posts that were not directly related to dentistry. These excluded items included memes, social images, or generic content from unrelated fields. After the initial screening, 804 valid posts remained.
These posts were then categorized according to the country of origin of the account owner, resulting in the exclusion of 720 posts that originated from countries other than Brazil. The final sample consisted of 84 Brazilian Portuguese posts related to BRD. The distribution of posts across the eight thematic categories is presented in Figure 1, and key descriptive characteristics across categories are summarized in Table 3.
Distribution of posts according to technical explanation, anatomical region, references, and clinical follow-up.
Distribution of Brazilian Instagram posts about Biomimetic Restorative Dentistry across thematic categories.
Clinical Sequence
A total of 36 posts were identified in this category, originating from 19 different Instagram accounts. All profiles belonged to dentists; of these, five included the word ‘biomimetic’ in their biography, and only two were verified accounts. Notably, three accounts were responsible for over 50% of the posts in this category (10, 6, and 3 posts each).
Among the 36 posts, 61.1% included some form of technical explanation (either in the caption or superimposed on the images), with a predominance of cases in the posterior region (97.2%). None of the posts included follow-up of the clinical case, and only two (5.6%) mentioned at least one scientific reference or source of information to support the technique performed (Figure 2).
Post characteristics within the “Clinical Sequence” category. Values are presented as number of posts (percentage within the category).
Education for Dentists
Twelve posts originating from six different Instagram accounts were identified in this category. All profiles belonged to dentists; two included the word ‘biomimetic’ in their biography, and only one account was verified. Notably, a single account accounted for 7 of the 12 posts, representing more than 50% of this category. Among the 12 posts, only two (16.7%) cited at least one scientific reference or source of information (Figure 3).
Presence of references across selected thematic categories. Values are presented as number of posts (percentage within each category).
Information for Patients
Eleven posts originating from six different Instagram accounts were identified in this category. All profiles belonged to dentists; four included the word ‘biomimetic’ in their biography, and none were verified accounts. Notably, one account was responsible for six of the eleven posts (over 50%), and none of the posts (0%) cited any scientific references or sources of information (Figure 3).
Professional Showcase
Ten posts were identified in this category, each on a different Instagram account. Nine accounts belonged to dentists and one to a dental technician; three accounts included the word ‘biomimetic’ in their biography, and two were verified. Six posts showed the laboratory phase of indirect restorations in the posterior region, three posts displayed aesthetic outcomes in the anterior region, and one post featured ceramic restorations involving both regions.
Before and After
Six posts were identified in this category, originating from five different Instagram accounts. All profiles belonged to dentists; one included the word ‘biomimetic’ in the biography, and one was a verified account. Three posts were related to the anterior region, and three to the posterior region.
Event Promotion, Event Documentation, and Miscellaneous Dental Content
Nine posts were identified across these three categories, each from a different Instagram account: Event Promotion (4), Event Documentation (3), and Miscellaneous Dental Content (2). All profiles belonged to dentists, except for those in the Event Promotion category, which were institutional profiles from dental schools, congresses, and dental supply companies.
Exploratory Statistical Analyses
Inferential analyses were restricted to the “Clinical Sequence” category, as it was the only subgroup with a sufficient sample size to yield interpretable contingency tables. In the remaining categories, the combination of small n and highly sparse tables (very low counts and/or zero cells) would have led to unstable effect estimates, inflated sampling variability, and low statistical power, thereby increasing the risk of inconclusive or misleading results. Therefore, no association tests were performed for those categories.
Within “Clinical Sequence”, no statistically significant associations were detected between the assessed post characteristics. Fisher’s exact test showed no association between technical explanation and presence of references (p = 0.511), or between technical explanation and anatomical region (p = 0.389). The profile verification status was not associated with technical explanation (p = 0.628) or presence of references (p = 1.000). Likewise, the presence of the term ‘biomimetic’ in the profile biography was not associated with the presence of references (p = 1.000), anatomical region (p = 0.472), or technical explanation (p = 0.790).
Discussion
This exploratory study analyzed Brazilian Instagram posts related to BRD and revealed a notable predominance of clinically oriented visual content over structured educational proposals. The findings offer insights into the characteristics, strengths, and limitations of the content published on Instagram regarding BRD, particularly within the Brazilian context.
The most frequent category was “Clinical Sequence” (43%) (Figure 1), encompassing posts that visually depicted clinical procedures in chronological order, essentially, step-by-step documentation of restorative techniques. Regarding the anatomical region presented, there was a clear predominance of posterior teeth (97.2%), likely reflecting the frequent indication of biomimetic techniques in the posterior sectors, where the goal is to restore the biomechanics of molars and premolars through adhesive restorations. However, a more detailed analysis revealed that not all the posts contained clear technical descriptions. In many cases, the visual narrative was sufficient to illustrate the different operative stages (isolation, preparation, restoration, and final outcome), but the accompanying text was minimal or absent, often limited to generic phrases or expressions of professional satisfaction, without describing clinical steps, therapeutic decisions, or materials used.
It is important to note that this study adopted a minimal threshold to define the presence of technical explanations, accepting both captions and text superimposed on images. A technical explanation was considered valid if it included references to the initial diagnosis, materials used, procedural steps, or clinical rationale. Nevertheless, 38.9% (14/36) of posts classified as “Clinical Sequence” contained no trace of technical explanation, suggesting that their primary purpose was not education but rather professional branding or aesthetic promotion. This finding underscores that, while visual formats have strong communicative potential, their educational value depends directly on the accompanying technical content. Thus, many of these posts, although structurally valuable for teaching, end up functioning more as promotional showcases than as pedagogical tools. Likewise, the profile verification status and the presence of the term ‘biomimetic’ in the biography were not associated with the inclusion of a technical explanation or references. This suggests that commonly perceived indicators of credibility may not reliably translate into more educational content.
Although a considerable number of posts fell under the “Clinical Sequence” category, it is important to note that none of the 36 posts included any follow-up evidence. This lack of longitudinal documentation limits the ability to validate the long-term effectiveness of the proposed innovative protocols and reinforces the need to share more complete and transparent content. Although Instagram is not a substitute for peer-reviewed scientific publications, its growing use as a platform for professional dissemination entails a degree of responsibility for the quality of the information shared. Displaying only the immediate outcome of a treatment without documenting its evolution may contribute to an idealized or biased perception. This absence also reflects a broader gap: the lack of clinical studies supporting some of the protocols proposed by BRD [5]. Although some professionals advocate biomimetic principles based on clinical experience, such claims are not always accompanied by rigorous documentation or longitudinal follow-ups. The ease of posting on social media, combined with the visual appeal of clinical cases, may explain their popularization; however, the absence of follow-up documentation in the analyzed posts compromises the potential of these platforms to meaningfully contribute to scientific knowledge.
Despite Instagram’s potential as a tool for continuing professional education, posts classified under “Education for Dentists” accounted for only 14% of the total sample. This category includes content covering theoretical concepts, scientific foundations, and recommendations for clinical protocols specifically aimed at dental professionals. This finding contrasts with the growing evidence supporting the use of social media as an effective educational environment in the health field. In a systematic review, Chen and Wang [19] observed that health professionals use these platforms to enhance digital literacy, acquire clinical information, and strengthen professional performance. Complementarily, Alasnag et al. [20] highlighted the value of platforms such as Twitter and Facebook in facilitating educational activities, such as journal clubs, case discussions, and virtual mentorships. Nonetheless, both studies emphasize the importance of promoting evidence-based content, as the lack of peer review mechanisms may facilitate the spread of unverified information.
Although the category “Information for Patients” represented 13% of the sample, a more detailed qualitative analysis revealed two clearly distinct types of content within this group. On the one hand, some posts aimed at promoting oral health education; seven posts addressed topics such as plaque disclosing agents, proper brushing techniques, bad breath in patients with veneers, the importance of regular cleaning, dental calculus, indications for resin veneers, and flossing recommendations. These posts served an educational function for the general public, using accessible language with the potential to raise awareness. On the other hand, four posts sought to explain what BRD is and how it could benefit patients without directly addressing self-care behaviors or basic oral health principles. In these cases, the discourse seemed more oriented toward highlighting professional differentiation and the philosophical appeal of the treatment approach, functioning as a positioning and patient-attraction strategy.
A smaller proportion of posts were classified under “Professional Showcase” (12%) and “Before and After” (7%), categories that included completed restorations or work on models, usually without technical explanations. These posts focus on aesthetic results or operative skills, typically accompanied by promotional, emotional, or self-branding language. This type of visual content is highly valued on Instagram, a platform where aesthetics and visual impact often take precedence over scientific content. Interestingly, these two categories showed a higher proportion of anterior cases (30-50%) compared to only 2.8% in the “Clinical Sequence” category.
A noteworthy finding is that among posts classified under “Clinical Sequence,” “Education for Dentists,” and “Information for Patients,” only 5.6%, 16.7%, and 0%, respectively, included references or information sources (Figure 3). This lack weakens the scientific credibility and rigor of the shared content, and may contribute to the dissemination of unverified information. Although Instagram was not conceived as an academic platform, there is a growing consensus among health professionals regarding the importance of sharing information backed by credible sources to counter misinformation and preserve content reliability [21]. In this regard, the JAMA benchmark criteria, one of the most recognized frameworks for evaluating the quality of medical information in digital environments, states that all content should appropriately attribute its sources, thus reinforcing transparency and trust [22]. Although Internet is increasingly used to disseminate dental information, multiple investigations have reported that only a small proportion of dental websites or social media provide references or cite their sources [23-25]. These findings support the need to strengthen citation practices on digital platforms, including Instagram, to improve the trustworthiness of content delivered to both professionals and patients.
Finally, other forms of communication related to BRD were identified that, while not directly educational or clinical in nature, serve an important role in academic and professional dissemination. The categories “Event Promotion,” “Event Documentation,” and “Miscellaneous Dental Content” included posts promoting courses, congresses, or products related to this restorative philosophy, as well as general dental messages that made some reference to biomimetics. Although fewer in number, these posts reflect the strategic use of Instagram to strengthen professional networks, highlight participation in academic activities, and maintain a visible presence in the digital dental ecosystem.
This study has some limitations inherent to its exploratory nature. Posts were selected using specific hashtags, which may have excluded relevant but untagged content. Another important limitation is that English-language hashtags were excluded, which may have omitted Brazilian users who preferentially tag in English and may reduce the representativeness of the sample; however, incorporating English hashtags would likely have required screening a substantially larger pool of posts due to the global volume of English-tagged content, thereby reducing the efficiency of identifying Brazilian Portuguese posts. Additionally, user interaction and comments were not analyzed, which could enrich future analyses of the impact of these posts. Furthermore, Instagram’s algorithm, which prioritizes content based on its relevance or engagement, may have influenced the final sample. Future studies should also evaluate whether posts labeled as biomimetics genuinely reflect this philosophy, as the boundary between BRD and contemporary Adhesive Dentistry is often blurred.
Despite these limitations, this study represents, to the best of our knowledge, the first systematic examination of Brazilian Portuguese content in BRD on Instagram. The findings provide a foundation for reflecting on how this clinical philosophy is being disseminated and what opportunities exist to improve the quality of shared content.
Conclusion
Brazilian Instagram posts related to Biomimetic Restorative Dentistry are characterized by a predominance of visually oriented content focused on clinical practice, limited technical information, scarce citation of references, and a complete absence of clinical follow-up. Although some posts demonstrate educational potential, most serve promotional or motivational purposes. These findings underscore the need to promote more rigorous professional communication on social media, including a scientific rationale and comprehensive clinical documentation. Although Instagram is not an academic platform, it can contribute to education when used responsibly and with technical discernment.
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Financial SupportNone.
Acknowledgments
The authors would like to express their sincere gratitude to Professor Dr. Alessandra Reis (State University of Ponta Grossa, Brazil) for her valuable contribution in performing the final review of this manuscript.
Data Availability
The data used to support the findings of this study can be made available upon request to the corresponding author.
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Edited by
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Academic Editor: Alessandro Leite Cavalcanti
