Effectiveness of bioactive resin materials in preventing secondary caries and retention loss in direct posterior restorations: A systematic review and meta-analysis.

OBJECTIVES

This systematic review aimed to determine whether bioactive resin materials can prevent secondary caries or enhance the longevity of direct posterior restorations.

DATA SOURCES: The protocol was registered in PROSPERO (CRD42024561179). The review followed PRISMA guidelines, utilizing a PICO framework. Studies were identified through searches in six databases (PubMed, Scopus, Cochrane, Embase, Scielo, Web of Science) up to May 2024.

STUDY SELECTION: Two independent reviewers applied inclusion criteria, selecting randomized clinical trials evaluating bioactive resin composites in restorative dentistry. Data were extracted into pre-designed forms, and article quality was assessed using the CONSORT, RoB 2, and GRADE tools. Meta-analyses focused on secondary caries incidence and restoration longevity using USPHS and FDI criteria.

RESULTS

Of 1,565 articles identified, 10 met the inclusion criteria. These studies, conducted in five countries, included 411 participants with follow-up periods ranging from 1 to 8 years. Materials evaluated included ACTIVA™ BioACTIVE, Giomer, and Cention N. Meta-analysis found no statistically significant differences between bioactive and conventional resin composites in preventing secondary caries or reducing retention loss (p > 0.05), the two primary outcomes considered in this review for assessing restoration longevity. Subgroup analysis showed no differences between follow-up periods.

CONCLUSIONS

Bioactive materials demonstrated similar clinical performance to conventional composites in preventing secondary caries and retaining restorations, offering no additional benefit in enhancing the longevity of direct posterior restorations.

CLINICAL SIGNIFICANCE: This review provides evidence that bioactive resin materials offer no significant clinical advantage over traditional composites, guiding (or informing) clinicians in (or about) material selection for restorative treatments.