Self-adhesive, bulk-fill bioactive materials as an alternative to silver amalgam in restorative dentistry

Abstract

Abstract Introduction: The disadvantages of silver amalgam fillings and the growing social requirements for the widespread availability of not only durable but also aesthetic dental fillings have contributed to the search for another basic restorative material that retains the advantages of silver amalgam and eliminates its disadvantages. The aim of the study is to present, on the basis of a literature review, the basic structure, properties and indications for the use of dental materials used in direct restorative dentistry, as well as new self-adhesive hybrid materials with simplified application technique. These are: Activa BioActive Restorative (Pulpdent; AB), Cention N (Ivoclar-Vivadent; CN), and SureFil One (Dentsply Sirona; SO). Basic information on the chemical structure and basic indications for the use of these materials were presented. Conclusions: The presented new materials are evolutionary products based on conventional glass ionomer cements (GIC), resin-modified glass ionomer cement (RM-GIC) and composite materials. The chemical structure and reactions that occur during the binding of AB and SO materials are similar to some RM-GIC, while in the case of CN material similar to fluorine-releasing resin-based materials. Previous studies do not confirm that the new materials have mechanical properties necessary to meet the requirements for posterior restorations. Considering limited clinical trials, care should be taken in their systematic application in all patients. There are no unequivocal studies confirming the bioactivity of the materials. Further in vitro studies as well as clinical observations to assess their chemical properties and the ability to induce remineralization and bioactivity are needed. The materials show self-adhesion but when included in the protocol of a bonding system, their adhesion to hard tissues is better.