Clinical effectiveness of alkasite versus nanofilled resin composite in the restoration of occlusal carious lesions in permanent molar teeth of children: a randomized clinical trial

H Sharma, B S Suprabha, R Shenoy, A Rao, H Kotian, H Sharma, B S Suprabha, R Shenoy, A Rao, H Kotian

Abstract

Purpose: To evaluate and compare the clinical effectiveness of alkasite with nanofilled resin composite restorations for occlusal caries lesions in permanent molar teeth of children, at one-year follow-up.

Methods: In this randomized controlled clinical trial with parallel design, 38 children aged 7-13 years with occlusal caries lesions on 59 first permanent molars were randomly allocated into two groups, Group 1: Filtek™ Z350XT (nanocomposite) and Group 2: Cention N® (alkasite resin composite). The restorations were evaluated at one year using the United States Public Health Service (USPHS) criteria. Data were analyzed using Chi-square or Fisher's exact test.

Results: All restorations had either Alpha or Bravo scores at one-year follow-up. In Group 1, all restorations scored Alpha, while one restoration each (3.6%) in Group 2 scored Bravo for fracture and marginal adaptation. All restorations in both groups scored Alpha for retention, secondary caries, and post-operative sensitivity. For anatomic form, all restorations in Group 1 scored Alpha, while three (10.7%) restorations in Group 2 had Bravo scores. For marginal discolouration, three restorations in both groups scored Bravo (11.5% and 10.7%, respectively). For surface roughness, one restoration (3.8%) in Group 1 and three restorations in Group 2 (10.7%) scored Bravo. The comparative results between the two groups for all the variables in the USPHS criteria were not statistically significantly different.

Conclusions: The performances of the nanofilled composite and alkasite were clinically acceptable and comparable. Alkasite can be an alternative material for the restoration of occlusal caries lesions in permanent molars of children.

Clinical trial registration: The clinical trial was registered at Clinical Trials Registry-India (CTRI Reg no: CTRI/2020/12/029830 Dated: 15/12/2020).

Keywords: Alkasite; Dental restoration; Molar; Nanocomposite; Permanent.

Conflict of interest statement

The authors declare that they have no conflict of interest.

© 2023. The Author(s).

Figures

Fig. 1
Fig. 1
Flow diagram representing flow of participants until 12 months in the study

References

    1. Alzraikat H, Burrow MF, Maghaireh GA, Taha NA. Nanofilled resin composite properties and clinical performance: a review. Oper Dent. 2018;43:E173–E190. doi: 10.2341/17-208-T.
    1. Askikfgajer V, Hainety FS, Hainety AS. FiltekTM Z350 XT Universal Restorative System TM. 3M ESPE, St. Paul, Minnesota, USA. 2002. Accessed 10 Sept 2019.
    1. Awad MM, Alshehri T, Alqarni AM, Magdy NM, et al. Evaluation of the bond strength and cytotoxicity of alkasite restorative material. Appl Sci. 2020;10:6175. doi: 10.3390/app10186175.
    1. Bastos NA, Bitencourt SB, Martins EA, De Souza GM. Review of nano-technology applications in resin-based restorative materials. J Esthet Restor Dent. 2021;33:567–582. doi: 10.1111/jerd.12699.
    1. Bayne SC, Schmalz G. Reprinting the classic article on USPHS evaluation methods for measuring the clinical research performance of restorative materials. Clin Oral Investig. 2005;9:209–214. doi: 10.1007/s00784-005-0017-0.
    1. Canali GD, Ignácio SA, Rached RN, Souza EM. One-year clinical evaluation of bulk-fill flowable vs. regular nanofilled composite in non-carious cervical lesions. Clin Oral Investig. 2019;23:889–897. doi: 10.1007/s00784-018-2509-8.
    1. Celik C, Arhun N, Yamanel K. Clinical evaluation of resin-based composites in posterior restorations: 12-month results. Eur J Dent. 2010;4:57–65. doi: 10.1055/s-0039-1697809.
    1. Chandrasekhar V, Rudrapati L, Badami V, Tummala M. Incremental techniques in direct composite restoration. J Conserv Dent. 2017;20:386–391. doi: 10.4103/JCD.JCD_157_16.
    1. Chole D, Shah HK, Kundoor S, Bakle S, Gandhi N, Hatte N. In vitro comparison of flexural strength of cention-n, bulkFill composites, light-cure nanocomposites and resin-modified glass ionomer cement. J Dent Med Sci. 2018;17:79â.
    1. de Andrade AK, Duarte RM, Medeiros e Silva FD, Batista AU, et al. 30-Month randomised clinical trial to evaluate the clinical performance of a nanofill and a nanohybrid composite. J Dent. 2011;39:8–15. doi: 10.1016/j.jdent.2010.09.005.
    1. de Paula AB, Fucio SBP, Ambrosano GMB, Alonso RCB, et al. Biodegradation and abrasive wear of nano restorative material. Oper Dent. 2011;36:670–677. doi: 10.2341/10-221-L.
    1. Dedania MS, Shah NC, Bajpai N. One year comparative evaluation of clinical performance of silver amalgam and cention-n in simple class I carious lesions in permanent molars randomized clinical. Int J Curr Res. 2018;10:72993–72996.
    1. Donly KJ, García-Godoy F. The use of resin-based composite in children: an update. Pediatr Dent. 2015;37:136–143.
    1. Firouzmandi M, Alavi AA, Jafarpour D, Sadatsharifee S. Fracture strength and marginal adaptation of conservative and extended mod cavities restored with cention N. Int J Dent. 2021;2021:5599042. doi: 10.1155/2021/5599042.
    1. Fisher J, Varenne B, Narvaez D, Vickers C. The Minamata Convention and the phase down of dental amalgam. Bull World Health Organ. 2018;96:436–438. doi: 10.2471/BLT.17.203141.
    1. Frascino S, Fagundes TC, Silva U, Rahal V, Barboza A, Santos PH, Briso A. Randomized prospective clinical trial of class ii restorations using low-shrinkage flowable resin composite. Oper Dent. 2020;45:19–29. doi: 10.2341/18-230-C.
    1. George P, Bhandary S. A comparative microleakage analysis of a newer restorative material–an exvivo study. IOSR J Dent Med Sci. 2018;17:56–60.
    1. Gjorgievska E, Nicholson JW, Iljovska S, Slipper IJ. Marginal adaptation and performance of bioactive dental restorative materials in deciduous and young permanent teeth. J Appl Oral Sci. 2008;16:1–6. doi: 10.1590/S1678-77572008000100002.
    1. Greene JG, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc. 1964;68(1):7–13. doi: 10.14219/jada.archive.1964.0034.
    1. Hegde N, Attavar S, Hegde MN, Hegde ND. Comparative analysis of bond strength and microleakage of newer generation bonding agents to enamel and dentin: an in vitro study. J Conserv Dent. 2020;23:593–597. doi: 10.4103/JCD.JCD_572_20.
    1. Hirani RT, Batra R, Kapoor S. Comparative evaluation of postoperative sensitivity in bulk fill restoratives: a randomized controlled trial. J Int Soc Prev Communit Dent. 2018;8:534–539. doi: 10.4103/jispcd.JISPCD_218_18.
    1. Ilie N. Comparative effect of self- or dual-curing on polymerization kinetics and mechanical properties in a novel, dental-resin-based composite with alkaline filler. Materials (basel). 2018;11:108. doi: 10.3390/ma11010108.
    1. Innes NP, Frencken JE, Bjørndal L, Maltz M, et al. Managing carious lesions: consensus recommendations on terminology. Adv Dent Res. 2016;28:49–57. doi: 10.1177/0022034516639276.
    1. Ismail AI, Sohn W, Tellez M, Amaya A, et al. The international caries detection and assessment system (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol. 2007;35:170–178. doi: 10.1111/j.1600-0528.2007.00347.x.
    1. Jayashankara CM, Jameela VA, Sharath Kumar P, Anil Kumar S, et al. An in vitro comparative evaluation of fracture resistance of dental amalgam, nano composite filtek-Z350 and cention-N in class II cavities. Int J Curr Adv Res. 2020;9:20896–20900.
    1. Lesaffre E, Philstrom B, Needleman I, Worthington H. The design and analysis of split-mouth studies: what statisticians and clinicians should know. Stat Med. 2009;28:3470–3482. doi: 10.1002/sim.3634.
    1. Loguercio AD, Rezende M, Gutierrez MF, Costa TF, Armas-Vega A, Reis A. Randomized 36-month follow-up of posterior bulk-filled resin composite restorations. J Dent. 2019;85:93–102. doi: 10.1016/j.jdent.2019.05.018.
    1. Manhart J, Chen H-Y, Neuerer P, Thiele L, et al. Clinical performance of the posterior composite QuiXfil after 3, 6, and 18 months in Class 1 and 2 cavities. Quintessence Int. 2008;39:757–765.
    1. Mazumdar P, Das A, Guha C. Comparative evaluation of hardness of different restorative materials (restorative gic, cention n, nanohybrid composite resin and silver amalgam)-an in vitro study. Int J Adv Res. 2018;6:826–832. doi: 10.21474/IJAR01/6737.
    1. Naz F, Samad Khan A, Kader MA, Al Gelban LOS, et al. Comparative evaluation of mechanical and physical properties of a new bulk-fill alkasite with conventional restorative materials. Saudi Dent J. 2021;33:666–673. doi: 10.1016/j.sdentj.2020.04.012.
    1. Roulet JF, Gummadi S, Hussein HS, Abdulhameed N, Shen C. In vitro wear of dual-cured bulkfill composites and flowable bulkfill composites. J Esthet Restor Dent. 2020;32:512–520. doi: 10.1111/jerd.12616.
    1. Sadeghi M, Lynch CD, Shahamat N. Eighteen-month clinical evaluation of microhybrid, packable and nanofilled resin composites in Class I restorations. J Oral Rehabil. 2010;37:532–537. doi: 10.1111/j.1365-2842.2010.02073.x.
    1. Sarrett DC. Clinical challenges and the relevance of materials testing for posterior composite restorations. Dent Mater. 2005;21:9–20. doi: 10.1016/j.dental.2004.10.001.
    1. Sealed Envelope Ltd. In: Power calculator for binary outcome non-inferiority trial. 2012. . Accessed 18 Sept 2019
    1. Sheen DH, Wang WN, Tarng TH. Bond strength of younger and older permanent teeth with various etching times. Angle Orthod. 1993;63:225–230.
    1. Soncini JA, Maserejian NN, Trachtenberg F, Tavares M, Hayes C. The longevity of amalgam versus compomer/composite restorations in posterior primary and permanent teeth: findings From the New England Children's Amalgam Trial. J Am Dent Assoc. 2007;138:763–772. doi: 10.14219/jada.archive.2007.0264.
    1. Stigers JI. Nonpharmacologic management of children’s behaviors. In: Dean JA, Avery DR, McDonald RE, editors. Mc Donald and Avery’s Dentistry for the child and adolescent. 10. St. Louis: Missouri: Elsevier; 2016. pp. 286–302.
    1. Tiskaya M, Al-Eesa N, Wong F, Hill R. Characterization of the bioactivity of two commercial composites. Dent Mater. 2019;35:1757–1768. doi: 10.1016/j.dental.2019.10.004.
    1. Todd JC. Scientific documentation: Cention N. Ivoclar-Vivadent Press, Schaan, Liechtenstein. 2016. . Accessed 14 Sept 2019
    1. van Landuyt KL, Kanumilli P, de Munck J, Peumans M, et al. Bond strength of a mild self-etch adhesive with and without prior acid-etching. J Dent. 2006;34:77–85. doi: 10.1016/j.jdent.2005.04.001.
    1. Yao C, Ahmed MH, Zhang F, Mercelis B, van Landuyt KL, Huang C, Van Meerbeek B. Structural/chemical characterization and bond strength of a new self-adhesive bulk-fill restorative. J Adhes Dent. 2020;22:85–97. doi: 10.3290/j.jad.a44000.
    1. Yazici AR, Antonson SA, Kutuk ZB, Ergin E. Thirty-six-month clinical comparison of bulk fill and nanofill composite restorations. Oper Dent. 2017;42:478–485. doi: 10.2341/16-220-C.

Source: PubMed

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