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Objectives: To compare the performance of Cention-N® with direct restorative materials used at the daily practice (e.g., resin-based composites/RBC, glass ionomer cements/GIC, bioactive resins, silver amalgam) via a systematic review study., Methods: The review followed the PRISMA-NMA recommendations, and the protocol of the review was published at osf.io/ybde8. The search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, Lilacs, and SciELO databases, as well as in the grey literature (Open Grey, Proquest, and Periódicos CAPES). Studies with an in vitro experimental design evaluating the characteristics and properties of Cention-N in comparison to other restorative materials were included. The risk of bias of included studies was assessed using the RoBDEMAT tool, and meta-analyses were conducted using Review Manager 5.4 and MetaInsight V3 tools., Results: A total of 85 studies were included in the review, from which 79 were meta-analyzed. Several characteristics of direct restorative materials were analyzed, including physical (color change, degree of conversion, hardness, microleakage, polymerization rate, roughness, water solubility, water sorption), mechanical (bond strength to dentin, compressive strength, diametral tensile strength, flexural modulus, flexural strength, load-to-fracture, wear), and biological (alkalinizing effect, antibacterial activity, calcium and fluoride release) properties., Significance: Cention-N presented similar physico-mechanical properties compared to RBCs, but a stronger behavior than GICs. Despite the Alkasite nature of Cention-N, GICs may still demonstrate the greatest fluoride releasing ability from all direct restorative materials. This review confirmed the adequate behavior of Cention-N when compared to several other more traditionally used materials, confirming its applicability for the permanent restoration of decayed or fractured teeth., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This study aimed to evaluate the micro-mechanical and macro-mechanical properties of self-cured and light-cured alkasite and to investigate how accelerated degradation in acidic, alkaline, and ethanol solutions affects the macro-mechanical properties of self-cured and light-cured alkasite. The specimens of the alkasite material (Cention Forte, Ivoclar Vivadent) were prepared according to the following three curing modes: (1) light-cured immediately, (2) light-cured after a 5-min delay, and (3) self-cured. Microhardness was tested before and after immersion in absolute ethanol to indirectly determine crosslink density, while flexural strength and flexural modulus were measured using a three-point bending test after accelerated aging in the following solutions: (1) lactic acid solution (pH = 4.0), (2) NaOH solution (pH = 13.0), (3) phosphate-buffered saline solution (pH = 7.4), and (4) 75% ethanol solution. The data were statistically analyzed using a two-way ANOVA and Tukey post hoc test. The results showed that the microhardness, flexural strength, and flexural modulus were significantly lower in self-cured specimens compared to light-cured specimens. A 5-min delay between the extrusion of the material from the capsule and light curing had no significant effect on any of the measured properties. A significant effect of the accelerated aging solutions on macro-mechanical properties was observed, with ethanol and alkaline solutions having a particularly detrimental effect. In conclusion, light curing was preferable to self-curing, as it resulted in significantly better micro- and macro-mechanical properties, while a 5-min delay between mixing the capsule and light curing had no negative effects. [ABSTRACT FROM AUTHOR]

The purpose of this in vitro study was to assess the color stability of esthetic restorative materials after immersion in different pediatric drugs. Three different restorative materials namely composite resin, alkasite and high-viscosity glass ionomer cement(HVGIC) were used to prepare total 96 (32 from each) disc-shaped specimens(2mmx5mm). A spectrophotometer was used to record the color of each sample after sample preparation and 7 days following the staining technique. After 1-week period, ΔE ∗ values were calculated. The average color changes(ΔE) for all drugs/restorative materials ranged from 1.81 to 8.08. The most prominent alteration was found in Cough syrup-Alkasite(8.08 ± 2.62) and the least one was found in Cough syrup-HVGIC(1.81 ± 0.74) pairwise. The color change observed in Cough syrup-Alkasite group was statistically significantly higher than in Cough syrup-HVGIC (p < 0.05). Alkasite showed greater color alteration with all drugs compared to other materials and HVGIC showed better color stability with all drug formulations. [ABSTRACT FROM AUTHOR]

Introduction. The hypomineralized enamel has risk of failure in direct restoration, because enamel fractures of the margins of the cavity adjacent to the restoration frequently occur, may cause loss of marginal integrity, so using a material bioactive in molar incisor hypomineralisation (MIH) would prevent direct restorations to be replaced frequently. No publications were found that indicate the remineralization capacity of these dental materials when the dental piece presents enamel defects. Objective. To compare in vitro the remineralization between Alkasite and Giomer in hypomineralized teeth. Methodology. 69 extracted human teeth were studied. 60 exposed to artificial saliva and lactic acid to hypomineralize them, all with Black Class I cavity filled with Alkasite (Group A) and Giomer (Group B); control (Group C) 9 untreated teeth. All preserved in artificial saliva at 37 °C. Mineral density was measured with Quantitative Light-Induced Fluorescense (QLF) on days 0, 7, 14, 21, and 28. Data were analyzed with ANOVA and Tukey with p < 0.05 of significance. Results. A decrease in the Mean and SD was observed from the beginning (4.689±1.781) to day 28 (2.556 ± 0.9152) of Alkasite; of the Giomer the initial Mean (6.978 ± 3.588) on day 28 (2.767 ± 0.5407), in both groups with a statistically significant difference (p < 0.0001). The Alkasite group and the control were observed at 28 days with readings without significant statistical difference (p = 0.1253). Conclusions. Under in vitro conditions and with QLF, both materials increased the mineral density, so they can be considered as restorative materials in hypomineralized molars. Alkasite achieved similar levels of mineral density to the control group. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of radiotherapy on the mechanical, chemical, and surface properties of two recently introduced restorative dental materials (a glass hybrid and an alkasite), while two conventional restorative materials served as references. Material specimens of the experimental groups (irradiated) were compared to the specimens of the control groups that underwent the same preparation procedure but without irradiation. The experimental groups of restorative material specimens were irradiated with a total of 70 Gy over 35 days (2 Gy/day × 35 days), while the control groups received no treatment. The following properties were evaluated: surface microhardness (Vickers), surface roughness, color change, flexural strength, flexural modulus, material reliability, and infrared spectra. For the experimental groups, measurements were performed 24 h after specimen preparation, i.e., before radiotherapy and after the completion of the irradiation protocol. For the control groups, measurements were performed after the corresponding periods of no treatment. A statistically significant increase in microhardness (p = 0.001–0.004) and surface roughness (p = 0.013) was observed as a result of material aging/maturation in both the control and experimental groups. However, the only statistically significant difference between the control and experimental groups was observed in the discoloration of the conventional reference material (p < 0.001). In conclusion, no statistically significant negative effects of a therapeutic dose of radiotherapy on any of the tested properties of the alkasite and glass hybrid materials were observed, whereas only a minor negative effect of radiotherapy in terms of discoloration was found for a conventional resin composite that was used as a reference material. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of pH and temperature on the ion (F− and Ca2+) release of a resin-based material containing alkaline fillers and a self-setting high-viscous glass ionomer cement. Disks were prepared according to manufacturers' instructions for both materials: the EF group (Equia Forte HT filling, GC) and the CN group (Cention N, Ivoclar). Specimens were immersed in 50 mL buffer solution with three different pHs (4.8, 6.8, and 8.8), and stored at 0°, 18°, 37°, and 44 °C. After 24 h, 7 d, and 28 d, cumulative F− and Ca2+ releases were analyzed by chromatography and mass spectrometry, and pH was measured. Both materials showed minimal changes in pH with final values after 28 d of 5.17 ± 0.56 for CN and 5.12 ± 0.24 for EF. In all experimental conditions, the percentages of ion release were higher for EF than for CF. In particular, both materials showed a significant difference in temperature in F− release. Regardless of the pH values, the highest Ca2+ ion release was after 28 days, with a significant difference in temperature for CN and EF. Within the limit of this study, the temperature storage influenced ion release and the high-viscous glass ionomer showed the maximum values. [ABSTRACT FROM AUTHOR]

Background: It has been claimed that an alkasite restorative material can neutralize acids produced by cariogenic bacteria from released hydrogen ions and enable to remineralization via calcium and fluoride ions. However, there is no evidence to support this assertion. Therefore, the aims of this study were to investigate the effect of the alkasite restorative material on the pH of Streptococcus mutans biofilm and dentin hardness. Methods: Streptococcus mutans biofilms were formed on Filtek™ Z350 (FZ, a resin composite) and Cention® N (CN, the alkasite restorative material) and their pH determined after 24 h. Hydroxide, fluoride, and calcium-ions released from the materials were determined at 6 h, 1, 3, 7, 14, and 28 days. Dentin specimens were prepared from 14 human molars and divided into four quadrants. Quadrant 1 was a sound dentin control, quadrants 2–4 were chemically demineralized, and a cylinder of FZ and CN placed on the surfaces of quadrants 2 and 4, respectively. The microhardness of quadrants 1 and 3 were measured at depths of 20, 40, and 60 µm from the occlusal surface, and similarly of quadrants 2 and 4, after 30 days. Independent t-test, Mann–Whitney-U, and repeated-measure-ANOVA were used for data analysis. Results: The pH of biofilm on CN (4.45) was significantly higher (p < 0.05) than that on FZ (4.06). The quantity of all ions released from CN was significantly higher than from FZ. The hardness of demineralized dentin under CN was significantly higher than that of demineralized dentin at all depths, and higher than that of demineralized dentin under FZ at 20 and 40 µm. Conclusions: CN released hydroxide, fluoride, and calcium ions, which was associated with raising the biofilm pH and the hardness of demineralized dentin. All results indicated that CN had the potential to reduce the incidence of secondary caries. [ABSTRACT FROM AUTHOR]

The objective was to evaluate new commercially available ion-releasing restorative materials and compare them to established anti-cariogenic materials. Four materials were tested: alkasite Cention (Ivoclar Vivadent) in self-cure or light-cure mode, giomer Beautifil II (Shofu), conventional glass-ionomer Fuji IX (GC), and resin composite Tetric EvoCeram (Ivoclar Vivadent) as a control. Flexural strength, flexural modulus, and Weibull modulus were measured one day, three months, and after three months with accelerated aging in ethanol. Water sorption and solubility were evaluated for up to one year. Degree of conversion was measured during 120 min for self-cured and light-cured Cention. In this study, Beautifil II was the ion-releasing material with the highest flexural strength and modulus and with the best resistance to aging. Alkasite Cention showed superior mechanical properties to Fuji IX. Weibull analysis showed that the glass-ionomer had the least reliable distribution of mechanical properties with the highest water sorption. The solubility of self-cured alkasite exceeded the permissible values according to ISO 4049. Degree of conversion of light-cured Cention was higher than in self-cure mode. The use of alkasite Cention is recommended only in the light-cure mode. [ABSTRACT FROM AUTHOR]

Acidic drinks are known to exert negative effects on the surface properties of dental restorative materials. However, the effect of increasingly popular green smoothie drinks has not been addressed so far. The present study investigated the effect of cyclic immersions (5 min daily over 30 days) in a green smoothie drink on the surface properties of contemporary dental restorative materials, including resin composites, an alkasite, and a glass hybrid. Vickers microhardness, profile roughness, and perceptible color change in the CIE L* a* b* color space were evaluated as clinically relevant properties of the material surface. After 30-day green smoothie immersion, microhardness values either decreased by 8–28% (for resin composites) or increased by up to 91% (for glass hybrid). The increase in profile roughness (Ra parameter) of smoothie-immersed specimens was 7–26 times higher compared to the control group. The perceptible color change (ΔE*) in the smoothie group was 3–8 times higher compared to the control group. Overall, this study demonstrated that daily exposure of dental restorations made from resin composites, alkasites, and glass hybrid materials to a green smoothie drink can significantly accelerate material degradation, which is reflected as surface softening, as well as higher roughness and higher perceptible color change. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of pH and temperature on the ion (F− and Ca2+) release of a resin-based material containing alkaline fillers and a self-setting high-viscous glass ionomer cement. Disks were prepared according to manufacturers’ instructions for both materials: the EF group (Equia Forte HT filling, GC) and the CN group (Cention N, Ivoclar). Specimens were immersed in 50 mL buffer solution with three different pHs (4.8, 6.8, and 8.8), and stored at 0°, 18°, 37°, and 44 °C. After 24 h, 7 d, and 28 d, cumulative F− and Ca2+ releases were analyzed by chromatography and mass spectrometry, and pH was measured. Both materials showed minimal changes in pH with final values after 28 d of 5.17 ± 0.56 for CN and 5.12 ± 0.24 for EF. In all experimental conditions, the percentages of ion release were higher for EF than for CF. In particular, both materials showed a significant difference in temperature in F− release. Regardless of the pH values, the highest Ca2+ ion release was after 28 days, with a significant difference in temperature for CN and EF. Within the limit of this study, the temperature storage influenced ion release and the high-viscous glass ionomer showed the maximum values.

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The aim of the study was to offer a comparative perspective on the mechanical and viscoelastic behavior of currently developed materials for simplified restoration concepts. These materials have not yet been clearly assigned whether they are complex hybrids of already known material categories or new material classes. A dual-cured, bulk-fill, bioactive resin-based composite (alkasite), a resin-modified glass ionomer cements (RM-GIC) with novel polymerizable acid polymers, and a glass ionomer cement (GIC) with improved adaptation to an acidic environment were compared with regard to their macro-mechanical parameters (3-point bending test, 3-PBT), fracture mechanism, quasi-static and viscoelastic behaviour (instrumented indentation test, IIT), morphology and structural appearance of the filler system (SEM analysis). The influence of surface finishing was quantified on the outcome of the 3-PBT, while the influence of aging and frequency was monitored on the outcome of the IIT. One and multiple-way analysis of variance (ANOVA) with Tukey honestly significant difference (HSD) post-hoc tests (α = 0.05) and Weibull analysis were applied. Surface finishing strongly influenced the outcome of the 3-PBT for RM-GIC and GIC but not of the alkasite. The highest material reliability (Weibull parameter m) was found with the alkasite, irrespective of the curing mode. Ground specimens showed decrease reliability, except for the alkasite in the light-cured mode. The predominant failure mode originated from sub-surface defects (52.5%), followed by corner (25%), edge (18.1%), and crack arrest (4.4%). The effect of the parameter material on the quasi-static outcome of the IIT was highest on elastic/plastic parameters (p < 0.001; e.g. elastic indentation work, η P 2 = 0.875), was moderate on the Martens Hardness (η P 2 = 0.420), and was low on the Vickers hardness (η P 2 = 0.218). The viscoelastic parameters, in particular the loss factor (tan δ) allow a clear documentation of the ongoing acid-base setting reaction during aging of one month, which was more pronounced in the GIC than in the RM-GIC. The decrease in tan δ with aging for GIC and RM-GIC reflects the maturation process and increased brittleness, while the increase in tan δ with aging reflects the polymer plasticization in the polymer-based alkasite. The mechanical and viscoelastic behavior depending on surface refinement, aging and frequency clearly allow to classify the currently developed materials for simplified restoration concepts into known material categories such as RBCs (alkasite), RM-GIC or GIC. [ABSTRACT FROM AUTHOR]

The purpose of this in vitro study was to investigate whether different types of experimental and commercial restorative dental materials can protect dentin against acid-induced softening. Experimental composites were prepared with a photocurable mixture of methacrylates and two types of bioactive glass (45S5 and a customized low-Na F-containing formulation). Human dentin samples were prepared from mid-coronal tooth slices and immersed in lactic acid solution (pH = 4.0) at 5 mm from set specimens of restorative material. After 4, 8, 12, 16, 20, 24, 28, and 32 days, surface microhardness of dentin samples and pH of the immersion solution were measured, followed by replenishing of the immersion medium. Microstructural analysis was performed using scanning electron microscopy. The protective effect of restorative materials was determined as dentin microhardness remaining statistically similar to initial values for a certain number of acid additions. Scanning electron microscopy showed a gradual widening of dentinal tubules and proved less discriminatory than microhardness measurements. To produce a protective effect on dentin, 20 wt% of low-Na F-containing bioactive glass was needed, whereas 10 wt% of bioactive glass 45S5 was sufficient to protect dentin against acid-induced demineralization. The anti-demineralizing protective effect of experimental and commercial restoratives on dentin was of shorter duration than measured for enamel in a previous study using the same experimental approach. [ABSTRACT FROM AUTHOR]