Long-term ion release, fluoride recharge, pH modulation, and mechanical aging of an experimental ACP-based composite...

This study evaluated the 12-month ion release, fluoride recharge capacity, pH modulation, mechanical aging, and structural reliability of an experimental amorphous calcium phosphate (ACP)-based composite compared to contemporary bioactive restorative materials.

An experimental ACP composite was compared with Activa™ BioACTIVE-Restorative, Cention N, and Surefil one ™. Calcium (Ca²⁺), phosphate (PO₄ ^3-), and fluoride (F^-) release, along with pH changes, were assessed over 365 days in artificial saliva. Fluoride recharge was performed at six months using a single application of 5000 ppm sodium fluoride gel, followed by cumulative fluoride re-release measurement for 30 days. The flexural strength and modulus were evaluated at baseline, 6 months, and 12 months. Statistical analysis was conducted using mixed-model ANOVA with post-hoc tests, and flexural strength reliability was assessed using Weibull analysis (α = 0.05).

All materials exhibited an initial burst of ion release, followed by a progressive decline (p = 0.001). The ACP composite demonstrated the highest early calcium and phosphate release but negligible fluoride release and significant reductions in mechanical properties and reliability after aging. Cention N showed sustained multi-ion release, the greatest alkalizing capacity, and stable mechanical performance. Surefil one™ achieved the highest fluoride release and recharge capacity while maintaining a near-neutral pH and superior mechanical reliability. The Activa™ BioACTIVE-Restorative exhibited moderate ion release and intermediate mechanical performance.

Bioactive restorative materials exhibit distinct material-dependent behaviors. Alkasite-based systems showed balanced ion release and mechanical stability, fluoride-focused systems demonstrated superior recharge and reliability, and the ACP composite provided primarily short-term calcium-phosphate release with limited long-term durability.