Evaluation of Clinical Performance of Alkasite Restorative Materials: A Systematic Review and Meta-Analysis

Ion-releasing restorative biomaterials have gained increasing attention in minimally invasive dentistry due to their potential to combine mechanical reliability with therapeutic functionality. Cention^® N is an alkasite-based restorative material designed to release fluoride, calcium, and hydroxyl ions while exhibiting mechanical properties comparable to resin-based composites. The present study aimed to systematically evaluate the clinical performance of this ion-releasing restorative material in comparison with conventional resin composites and glass ionomer cements. A comprehensive systematic search was conducted in PubMed (MEDLINE), Cochrane Library, Web of Science, Scopus, EMBASE, and SciELO databases up to 31 October 2024, following the PRISMA guidelines. Clinical studies assessing restorative performance outcomes were included. Meta-analyses were performed using Review Manager software (version 5.1). Fourteen studies met the inclusion criteria for qualitative synthesis, of which ten were eligible for quantitative analysis. The pooled results demonstrated comparable clinical performance between alkasite restoratives and resin-based composites regarding retention and secondary caries incidence, while superior outcomes were observed when compared with glass ionomer cements. Within the limitations of the available evidence, ion-releasing alkasite restorative materials represent a clinically acceptable alternative to conventional restorative options, combining functional biomaterial properties with reliable clinical performance. The conclusions should be interpreted within the context of the included studies, which exhibited clinical heterogeneity and, in several cases, a moderate risk of bias.