Clinical performance of alkasite and glass-hybrid restorations compared with resin composite in class II cavities: a randomized clinical trial

OBJECTIVES: The aim of this randomized clinical trial was to evaluate the 18-month clinical performance of alkasite and glass-hybrid restorations compared with resin composite in Class II restorations. MATERIALS AND METHODS: A total of 50 patients requiring at least three Class II restorations in premolar and molar teeth were recruited. Each patient received three restorations, which were randomly assigned to one of the following materials: an alkasite (Cention N, Ivoclar Vivadent), a glass-hybrid (Equia Forte HT, GC Corp.), or a resin composite (Gradia Direct Posterior, GC Corp.). Alkasite and glass-hybrid served as test groups while resin composite served as the control group. During the 18-month follow-up, restorations were scored at baseline, 6, 12, and 18 months using the FDI criteria. Data were analyzed using the Chi-square and Cochran's Q tests (α = 0.05). RESULTS: No significant differences were detected among the groups for esthetic, functional, or biological criteria over 18 months (p > 0.05). Regarding esthetic properties, the control group showed 100% success for all esthetic criteria at all recall visits, while the alkasite group maintained a 96% success rate at all time points, and glass-hybrid showed 98% success at 6 and 12 months and 92% at 18 months. Minor score-2 changes in color match and gloss were detected in the glass-hybrid and alkasite groups but were not significant (p > 0.05). For functional and biological outcomes, all groups achieved 100% success rates for all evaluated parameters. CONCLUSIONS: Alkasite and glass-hybrid groups exhibited clinical performance comparable to resin composite over the 18-month follow-up in Class II cavities. All materials demonstrated excellent functional and biological stability while achieving clinically acceptable aesthetic results.