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Resin composite and glass ionomer cement (GIC) are the most commonly used dental materials to perform direct restorations. Both have specific characteristics that explain their popularity and their limits. More than 20 years ago, the first attempt (followed by others) to combine the advantages of these two families was performed with compomers, but it was not very successful. Recently, new formulations (also called ‘smart materials’) with claimed ion release properties have been proposed under different family names, but there are few studies on them and explanations of their chemistries. This comprehensive review aims to gather the compositions; the setting reactions; the mechanical, self-adhesive, and potential bulk-fill properties; and the ion release abilities of the large existing families of fluoride-releasing restorative materials and the new restorative materials to precisely describe their characteristics, their eventual bioactivities, and classify them for an improved understanding of these materials. Based on this work, the whole GIC family, including resin-modified and highly viscous formulations, was found to be bioactive. Cention N (Ivoclar Vivadent, AG, Schaan, Lietschentein) is the first commercially available bioactive resin composite.

Background Cervical carious lesions present a clinical challenge due to several factors and require restorative materials with optimal performance. This trial evaluated the clinical performance and cost-effectiveness of low-shrinkage giomer resin composite (LS-GRC) compared to resin-modified glass ionomer (RMGI) for restoring cervical carious lesions over a 12-month period. Participants and methods A total of 56 class V cavities were randomly assigned to two groups ( n  = 28). Intervention group received LS-GRC (Beautifil II LS, Shofu Dental Corporation, Kyoto, Japan), and control group received RMGI (Fuji II LC, GC Corporation, Tokyo, Japan). Restorations were evaluated using revised FDI criteria at baseline, 6, and 12 months. Data were statistically analyzed with a significance level of P  ≤ 0.05. Intergroup comparisons were assessed with Chi-squared test, while intragroup comparisons were assessed with Cochran’s Q test. Incremental cost-effectiveness ratio (ICER) and cost per success ratio (CPSR) were used for cost-effectiveness analysis. Results After 12 months, intergroup comparisons revealed no significant differences for all outcomes ( P  > 0.05), except for surface luster and texture, which favored LS-GRC ( P  < 0.05). Intragroup comparisons revealed no significant differences within LS-GRC group ( P  > 0.016), while within RMGI group, significant differences were observed for surface luster and texture after 12 months ( P  < 0.016). ICER analysis showed that the cost for each additional 1% improvement in clinical outcomes with LS-GRC was approximately 1.6 times higher than that of RMGI. The CPSR for LS-GRC was 4.6% lower than that of RMGI, indicating that, despite its higher initial cost, LS-GRC provided comparable clinical performance, with significantly improved esthetic surface quality and favorable cost-effectiveness over the 12-month period. Conclusions LS-GRC and RMGI exhibited comparable performance and were clinically acceptable after 12 months. Clinical relevance Low-shrinkage giomer resin composite offers bioactivity, superior restoration integrity, and excellent esthetics, helping achieve optimal cervical restorations with improved clinical success, durability, and sustained cost-effectiveness. Trial registration https://clinicaltrials.gov/ , (NCT05930548), 30–06–2023. Graphical Abstract

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.

The longevity and acceptance of aesthetic dental materials are directly proportional to color stability. The aim of this study was to analyze the relationship between the use of multivitamins and the color stability of dental restorative materials. A total of 45 discs of nanohybrid composite, 45 of Reinforced Glass Ionomer (RGI), and 45 of Giomer were prepared. Subsequently, the samples were randomly divided into three solution groups (n = 15): Group 1—Sambucol Pediatric Syrup, Group 2—Hidropolivital Baby Drops, and Group 3—artificial saliva, which is preparation for patients with xerostomia. For 28 days, the specimens were immersed in 10 mL of each multivitamin for two minutes every 24 h. Color measurements were repeated on days 7, 14, 21, and 28. Statistical analysis was performed using the Jamovi software version 2.2.5, employing the Shapiro–Wilk test for normality and the Kruskal–Wallis test for non-parametric data. When comparing materials, statistically significant differences (p < 0.001) were observed between RGI and Giomer, and RGI and composite, but not between Giomer and composite (p = 0.716). The highest change was observed in RGI–Hidropolivital ΔE00 = 3.27 (2.38–4.59) and the least in composite–Sambucol ΔE00 = 0.72 (0.30–1.18). In conclusion, the exposure time and the multivitamin influence the color change of restorative materials.

The aim of the study is to evaluate the effect of fluoride varnishes on both the color stability and surface microhardness of different fluoride-releasing restorative materials exposed to beverages commonly consumed by children . This study was conducted as an in vitro experimental study design. Three different restorative materials (Dyract XP, Beautifil II, and Cention N) and a colorless fluoride varnish were used. The solutions in which the samples were immersed were selected as beverages commonly preferred by children: cherry juice, chocolate milk, and cola. Color changes of the samples were measured using a spectrophotometer at 1, 7, 14, and 28 days and calculated according to the CIEDE2000 total color difference formula. Surface microhardness values were measured using a digital microhardness testing device at 1 and 28 days. To assess the effects of variables and their interactions in repeated observation designs, generalized linear models and generalized linear mixed models were fitted. Following model estimation, Tukey’s-adjusted estimated marginal means were computed to identify significant pairwise differences. Fluoride-releasing restorative materials exhibited varying degrees of color change and decrease in surface microhardness when immersed in different staining solutions. Among the tested materials, Cention N demonstrated the greatest color stability (ΔE=1.01 for fluoride applied group, ΔE=1.45 for the group without fluoride application) and least reduction in surface microhardness. Fluoride application initially caused a slight discoloration immediately after application. However, following immersion in different solutions, fluoride application appeared to enhance color stability (ΔE=1.59 in the varnish-applied group, ΔE=2.21 in the group without varnish application), but did not have a statistically significant effect on the surface microhardness. A negative correlation was observed between color change and surface microhardness; as the surface microhardness decreased, the extent of color change increased. This study highlights the prominent role of intraoral environmental factors in influencing the durability and aesthetic properties of fluoride-releasing restorative materials. Topical fluoride application has a beneficial effect on the color stability with a more pronounced effect observed with Cention N. Graphical abstract

Preheating the high-viscosity forms of bulk-fill resin composites is recommended to enhance their flow and adaptability. Nevertheless, the impact of preheating on their characteristics upon exposure to carbonated beverages remains unclear. This study aims to evaluate the effect of a Cola beverage on the properties of preheated and non-preheated high-viscosity bulk-fill composite resins . Forty disc-shaped specimens were prepared from each of BEAUTIFIL-Bulk Restorative (BB) and Filtek One Bulk-fill (FOB) composite resin, then divided into two groups (  = 20), either preheated to 68°C for 15 min or kept at room temperature before polymerization, then specimens were immersed in Alkozay Cola beverage for 30 days (3 periods of 15 min/day). Color stability (ΔE ), surface gloss (GU) and Vickers Microhardness (VHN) were recorded before and after the Cola immersion. The data was analyzed with Two-way ANOVA, Three-way ANOVA and Tukey's HSD test using SPSS software at 95% significance level. The color change was significantly higher in BB than FOB in all groups (  < 0:001), FOB had a significant reduction in color change after preheating (  < 0.05) while BB had no significant change (  > 0.05). Preheating significantly increased the gloss of BB and reduced that of FOB (  < 0.001), however, Cola beverage significantly reduced the gloss of all the groups (  < 0.001). Preheating significantly increased the microhardness of both materials (  < 0.001), however, Cola beverage significantly reduced the microhardness of all the groups (  < 0.001). Although the preheating of high-viscosity bulk-fill composites significantly improved their microhardness and improved the surface gloss of FOB, it did not protect both composites against the Cola drink attack. Preheated FOB showed improved color stability after the Cola immersion, but not to a clinically acceptable limit.

Background Molar-incisor hypomineralization (MIH) is a common condition among children that significantly increases the risk of caries. The objective of this research was to evaluate the clinical success of giomer- and conventional resin-based sealants applied on first permanent molars (FPMs) affected by MIH. Methods One-hundred FPMs with MIH which were indicated for non-invasive fissure sealant were selected in 39 children, aged 6–12 years. Using a split mouth design, the FPMs were randomized into two groups; Group 1. Resin sealant (etch-and-rinse + Conceal F) and Group 2. Giomer sealant (self-etch primer + BeautiSealant). Clinical evaluation was performed using the modified United States Public Health Service (USPHS) criteria at 1, 3, 6 and 12 months. The Log-rank, Fisher’s exact test and Kaplan–Meier analysis were used for statistical analysis. Results At 12 months, the retention rates in Group 1 and Group 2 were 68% and %8, respectively ( p  = 0.000). The cumulative survival rates of conventional resin sealants were significantly higher than giomer sealants for all follow-up visits ( p  < 0.05). In Groups 1 and 2, the distribution of unsuccessful sealants on mandibular vs maxillary FPMs were 32.1% vs 31.8% ( p  = 0.612) and 91.7% vs 92.3% ( p  = 0.664), respectively. Although the success rate was higher for teeth with white opacities or lesions with less extension in Group 1, no significant difference was found. The average survival time was found as 10.46 ± 3.21 months in Group 1 and 4.02 ± 4.43 months in Group 2. Conclusions The conventional resin-based sealants yielded a better clinical performance over the 12-month evaluation period than the giomer sealants which were applied with self-etch primer. The high failure rate observed in giomer sealants could be explained by the possible deficiency in the etching capacity of self-etch primer on MIH-affected teeth. Trial registration ClinicalTrials.gov, NCT04929782. Registered 10 June 2021—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04929782 .