Clinical Performance of Bioactive Restorative Materials

Clinical Performance of Bioactive Restorative Materials in Occlusal Restorations: Preliminary Results of a Split-mouth Study

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.

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).

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.