Dental Adhesive Materials, Dental Caries
Conditions
Keywords
Bioactive Restorative Materials, Dental Restorations, Clinical trial, FDI-2 criteria
Brief summary
The aim of this clinical study is to evaluate the performance of three different bioactive restorative materials against a composite resin for a period of 9 months. This randomized, split-mouth, single-center trial was performed on patients having occlusal caries (ICDAS 3 and 4) in both molars of the same jaw. The restorative materials used were Tetric N-Ceram Bulk-fill (control, Ivoclar Vivadent, Liechtenstein), Stela (SDI, Australia), Cention Forte (Ivoclar) and Activa BioActive Restorative (Pulpdent, USA). The restorations were evaluated at baseline, 3-6 and 9-month according to FDI-2 criteria, in terms of functional, biological, and aesthetic parameters, by two experienced evaluators.
Detailed description
Objectives: To clinically evaluate the performance of three different bioactive restorative materials against a composite resin for a period of 9 months. Materials and Methods: This randomized, split-mouth, single-center trial was performed on patients having occlusal caries (ICDAS 3 and 4) in both molars of the same jaw. The restorative materials used were Tetric N-Ceram Bulk-fill (control, Ivoclar Vivadent, Liechtenstein), Stela (SDI, Australia), Cention Forte (Ivoclar) and Activa BioActive Restorative (Pulpdent, USA). The material allocation was randomly assigned by a drawing lot. The restorations were evaluated at baseline, 3-6 and 9-month according to FDI-2 criteria, in terms of functional, biological, and aesthetic parameters, by two experienced evaluators. Chi-square test was used to compare the variables in the categories. Mann-Whitney U test and paired T test compared the difference in scores for the groups (p\<0.05).
Interventions
PROCEDURETetric N Ceram Bulkfill application
Selective enamel etching was performed with 37% phosphoric acid followed by a universal adhesive system application to all cavity surfaces and LED cured. The bulk-fill composite resin was placed in a single increment according to the manufacturer's recommendations and light-cured for 20 seconds. Excess material was removed using flame-shaped diamond finishing burs. Occlusion was assessed with articulation paper, and premature or undesirable contact points were adjusted as necessary.
PROCEDURECention Forte application
A drop of Cention Primer was mixed in its wheel for 5 seconds and actively applied to the cavity for 10 seconds, followed by gentle air-drying. The Cention Forte capsule was then mixed for 15 seconds in a capsule mixer and placed in bulk into the prepared cavity using the manufacturer's delivery gun. Light curing was performed for 20 seconds with an LED unit (1300 mW/cm²; ZenoLite, President, Germany). Excess material was removed using flame-shaped diamond finishing burs. Occlusion was assessed with articulation paper, and any premature or undesirable contact points were adjusted accordingly. Final polishing was performed with OptraGloss polishing wheels (Ivoclar Vivadent) for 20 seconds.
PROCEDUREStela Automix
Stela Primer was applied to the cavity surfaces and margins for 10 seconds. After a 5-second waiting period, the primer was gently air-dried for 2-3 seconds. The Stela Automix injector tip was then angled as needed and inserted into the cavity to deliver the material. The restoration was allowed to self-cure for 4 minutes. Occlusion was evaluated using articulation paper, and any premature or undesired contact points were adjusted as necessary. Final polishing was performed with OptraGloss polishing wheels (Ivoclar Vivadent) for 20 seconds.
PROCEDUREActiva BioActive Restorative
Selective enamel etching was performed with 37% phosphoric acid for 15 seconds, followed by thorough rinsing and air-drying. A universal adhesive system (Tetric N-Bond Universal, Ivoclar Vivadent) was applied to all cavity surfaces, including enamel, for 20 seconds, air-thinned, and light-cured for 20 seconds using an LED unit (1300 mW/cm²; ZenoLite, President, Germany). Following the manufacturer's instructions, the placement tip was inserted into the cavity using the dedicated placement gun, and the material was delivered in bulk. Light curing was performed for 20 seconds. Excess material was removed using flame-shaped diamond finishing burs. Occlusion was assessed with articulation paper, and premature or undesirable contact points were adjusted as needed. Final polishing was performed with OptraGloss polishing wheels (Ivoclar Vivadent) for 20 seconds.
Sponsors
Ege University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Intervention model description
Randomized split mouth study design
Eligibility
Sex/Gender
ALL
Age
20 Years to 34 Years
Healthy volunteers
No
Inclusion criteria
* Individuals over the age of 16 with permanent dentition * Individuals with a total of four vital molar teeth requiring restoration (ICDAS 3-4), two on each side of the same jaw * Individuals with posterior contact with antagonist teeth * Individuals who are reliable, cooperative, and willing to participate in periodic follow-ups
Exclusion criteria
* Individuals whose antagonist teeth were missing or have crowns, bridges, etc. * Individuals with history of alcohol, drug, or medication addiction. * Individuals with pulp exposure during cavity preparation or a cavity depth exceeding 2-4 mm. * Individuals known to be unable to attend follow-up appointments. * Individuals with allergies to the products used in the procedure. * Individuals with severe tooth grinding or bruxism. * Individuals with caries conditions classified as ICDAS 5 and 6. * Pregnant or breastfeeding individuals and individuals planning pregnancy during the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| FDI-2 evaluation criteria for functional properties | 2 years | Clinical evaluations were conducted using the FDI-2 criteria by two experienced, calibrated, and blinded evaluators for functional properties (category F). fracture/displacement of the material, marginal adaptation, form and contour, occlusion, and wear) were scored. Scores of 1-3 indicate clinically acceptable and successful restorations, score 4 indicates clinically inadequate but repairable defects, and score 5 represents clinically unacceptable restorations. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| FDI-2 evaluation criteria for biological properties | 2 years | Clinical evaluations were conducted using the FDI-2 criteria by two experienced, calibrated, and blinded evaluators for biological properties (category B). Secondary caries, integrity of tooth structure at restoration margins, post-operative sensitivity, and pulp status) were scored. Scores of 1-3 indicate clinically acceptable and successful restorations, score 4 indicates clinically inadequate but repairable defects, and score 5 represents clinically unacceptable restorations. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORCankut Canevi, DDS
Ege University School of Dentistry Department of Restorative Dentistry
Outcome results
None listed