Is Cention-N comparable to other direct dental restorative materials? A systematic review with network meta-analysis of in vitro studies.

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.

Comparison of microleakage of an alkasite restorative material, a composite resin and a resin-modified glass ionomer

Aim: To compare the microleakage of Cention N, a subgroup of composite resins with a resin-modified glass ionomer (RMGI) and a composite resin. Methods: Class V cavities were prepared on the buccal and lingual surfaces of 46 extracted human molars. The teeth were randomly assigned to four groups. Group A: Tetric N-Bond etch-and-rinse adhesive and Tetric N-Ceram nanohybrid composite resin, group B: Cention N without adhesive, group C: Cention N with adhesive, and group D: Fuji II LC RMGI. The teeth were thermocycled between 5°-55°C (×10,000). The teeth were coated with two layers of nail vanish except for 1 mm around the restoration margins, and immersed in 2% methylene blue (37°C, 24 h) before buccolingual sectioning to evaluate dye penetration under a stereomicroscope (×20). The data were analyzed by the Kruskal-Wallis and Wilcoxon tests (α=0.05). Results: Type of material and restoration margin had significant effects on the microleakage (p<0.05). Dentin margins showed a higher leakage score in all groups. Cention N and RMGI groups showed significant differences at the enamel margin (p=0.025, p=0.011), and for the latter group the scores were higher. No significant difference was found at the dentin margins between the materials except between Cention N with adhesive and RMGI (p=0.031). Conclusion: Microleakage was evident in all three restorative materials. Cention N groups showed similar microleakage scores to the composite resin and displayed lower microleakage scores compared with RMGI

Cention-N: una opción restaurativa directa e innovadora para el sector posterior

RESUMEN Introducción: La industria odontológica está en constante evolución respecto a la concreción de materiales dentales que mejoren la calidad de vida. Sin embargo, debido al gran número de estos, es imprescindible realizar comparaciones de propiedades biomecánicas que definan los de mejor rendimiento. Objetivo: Identificar las ventajas y desventajas del material de restauración Cention-N, con respecto a la resina compuesta, el ionómero de vidrio y la amalgama. Métodos: Se hizo una investigación bibliográfica en las bases PubMed, Scielo, Semantic Scholar, ScienceDirect, Medigraphyc y Redalyc. Se usaron como palabras clave: Cention-N, material restaurativo, amalgama, resina compuesta, el ionómero de vidrio; combinadas con operadores booleanos AND y OR. Se seleccionaron artículos originales y de revisión, entre otros documentos, para examinar 4 características: microfiltración, dureza, rugosidad superficial y resistencia al cizallamiento. El 50 % de los artículos escogidos se publicaron en los últimos 5 años. Resultados: Se seleccionaron un total de 13 artículos, 1 página web y 1 libro, acorde con los filtros de selección y objetivo de investigación. El Cention-N, con respecto a los demás materiales considerados, presentó menor puntuación de microfiltración (0,28 ± 0,18), mayor dureza (77 N/mm2), menor rugosidad (442,98 ± 62,45 nm) y mayor resistencia al cizallamiento (14,38 ± 3,88 MPa). Resta evaluar sus propiedades mecánicas ante procedimientos abrasivos como el blanqueamiento dental y a cargas altas como en el bruxismo. Conclusión: Cention-N es una opción prometedora como material restaurador del sector posterior al evidenciar una menor microfiltración y rugosidad; así como mayor resistencia al cizallamiento y dureza, en comparación con otros materiales restaurativos estudiados.

ABSTRACT Introduction: Dental industry is constantly evolving regarding the realization of dental materials that improve the quality of life. However, due to the large number of these, it is essential to perform intercomparisons of biomechanical properties that define those with the best performance. Objective: To identify the advantages and disadvantages of Cention-N restorative material with respect to composite resin, glass ionomer and amalgam. Methods: A bibliographic search was made in the PubMed, Scielo, Semantic Scholar, ScienceDirect, Medigraphyc and Redalyc databases. The following keywords were used: Cention-N, restorative material, amalgam, composite resin, the glass ionomer; combined with Boolean AND and OR operators. Original and review articles, among other documents, were chosen to examine 4 characteristics: microfiltration, hardness, surface roughness and shear resistance. 50% of the articles are from the last 5 years. Results: A total of 13 articles, 1 webpage and 1 book, were found according to the selection filters and research objective. The Cention-N, with respect to the other materials considered, presented a lower microfiltration score (0,28 ± 0,18); higher hardness (77 N/mm2); lower roughness (442,98 ± 62,45 nm) and higher shear strength (14,38 ± 3,88 MPa). However, it remains to evaluate its mechanical properties before abrasive procedures such as teeth whitening and at high loads such as bruxism. Conclusion: Cention-N is a promising option as a posterior sector restorative material as it shows less microfiltration and roughness; as well as greater resistance to shear and hardness, compared to other restorative materials studied.