JOURNAL CLUB 3

CENTION N
VAISHNAVI BORSE
 Cention N

• What is it?
• Why is it so special?
1) Alkaline filler- Acid neutralizing
2) Isofiller – Counteracting polymerization shrinkage
3) Fluoride release
• Limitations
Comparative Evaluation of Microleakage of Three Different Direct Restorative Materials (Silver Amalgam,
Glass Ionomer Cement, Cention N), in Class II Restorations Using Stereomicroscope: An In vitro Study

Paromita Mazumdar, Abiskrita Das

Indian Journal of Dental Research
2019
 AIM

The aim of the study is to compare the microleakage of three

different direct restorative materials (amalgam [AA], glass
ionomer cements [GICs], and Cention N [CN]) in Class II
restorations using stereomicroscope
 METHOD

1. Thirty recently extracted sound mandibular first molars

collected
2. Residual organic tissue from the teeth was removed
3. Then, the teeth were immersed in 2.6% sodium
hypochlorite solution and rinsed with running water for 10
min.
Cavity preparation

• A standardized Class II cavity preparation was made

involving the proximal and occlusal surfaces using no. 245
tungsten carbide bur with a high‑speed air rotor handpiece
and water spray
• Standardized cavities: occlusal floor ‑ width 4 mm, length 5
mm; axial wall ‑ width 4 mm, height 3 mm; gingival floor ‑
width 4 mm, depth 2.5 mm
All the prepared samples were divided into 3 experimental
groups, with 10 teeth in each group

Group Group
Group I:
II: III:
●
Silver (AA) Type II GIC
●
Cention(CN)
●
• The restored teeth were stored for 24 h in distilled water and
thermocycled for 500 cycles between 5°C and 55°C with a dwell
time of 30 s in each bath
• The apices of the specimens were sealed with a sticky wax and all
tooth surfaces were covered with two coats of clear nail polish with
the exception of 1 mm around the tooth‑restoration margins and
allowed to air dry
• Samples were immersed in 0.5% basic fuchsin dye for 24 hr
• Teeth were sectioned along the mesiodistal direction, coincident
with the center of the restoration, using a diamond disc under
water spray
• Stereomicroscope-
The dye penetration of the occlusal
and gingival margins of each section
was evaluated independently by the
observer using a stereo‑microscope at
a magnification of 22.5× and the
microleakage of occlusal and gingival
margins of Class II cavities were
evaluated based on a scoring criteria.
Amalgam GIC

Cention N
 Table 1: Score criteria of microleakage
Score Tooth‑restoration interface Score criteria
(proportions)
(Leakage Proportion)
1 no dye penetration 0.00
2 dye penetration up to the first‑third of 0.25
the prepared cavity wall
3 dye penetration up to the second‑third 0.50
of the prepared cavity wall
4 dye penetration into the entire prepared 0.75
cavity wall
5 dye penetration into the entire prepared 1.0
cavity wall and the pulpal wall
FIGURE 1

FIGURE 2
 Statistical Analysis

Descriptive statistical analysis was performed to calculate

the means with corresponding standard deviation.
Besides this, one‑way ANOVA followed by post hoc
Tukey’s test was performed to compare the mean values.
P < 0.05 was taken to be statistically significant
 Results

Distribution of microleakage score of different restorative materials

Graphical representation of Mean and standard deviation of three groups
 Discussion

• Microleakage
• Dye penetration method
• GIC
• Cention N exhibiting marginally better performance
to GIC
 Conclusion

Within the limitations of the current study, the following

conclusions were drawn:
• All the restorative materials used in the study were unable to
prevent the microleakage completely.
• Out of all the restorative materials, CN a newer restorative
material displayed minimum microleakage compared to AA and
GICs.
Comparison of fluoride ion release and
alkalizing potential of a new bulk-fill
alkasite
Nupur Gupta, Shikha Jaiswal, Vineeta Nikhil, Sachin Gupta
Journal of Conservative Dentistry
2019
 AIM

To evaluate and compare fluoride ion release by Cention N

(self cure and light cure) and conventional glass ionomer
cement (GIC) at different time intervals and pH.
 METHOD

1. Fourty five freshly extracted human permanent mandibular

molar were collected
2. Then they were disinfected with 0.1% thymol solution and
stored in normal saline
3. Later, the teeth were sectioned at the level CEJ
4. Each sample was then sectioned into 4 equal sections
mesiodistally and buccolingually to obtain 180 samples.
4) Following this, standardized cavities were made
5) The cavities in all the groups were restored with
respective restorative materials which were
manipulated according to the manufacturer's
instructions.
6) All the samples were then incubated in 95% relative
humidity at 37°C for 24 h. Later, two layers of nail
varnish were used to coat the samples, leaving a
margin of 1 mm around the restoration.
 GIC(G) Cention(CS) Cention(CL)

pH-6.8 pH-6.8 pH-6.8

pH-4 pH-4 pH-4

Time-
7 days
14 days
21 days

The samples (n = 180) were randomly divided into the following three equal groups (n = 60): GIC (G),
Cention-N – Self-cure (CS), and Cention-N – Light cure (CL).
• In order to carry out this experiment, 180 plastic containers were
prepared each containing 5 ml of deionized water/acidic medium
which was replaced after every 24 hr.
• Ten samples from each of the subgroups were stored in each of
these plastic containers for evaluation of cumulative fluoride
release at 24 hr , 7 days and 14 days interval and the solution so
obtained at the end of the respective time interval was used for
evaluation of the amount of fluoride release.
• The cumulative fluoride ion release and change in pH were
assessed at the end of 7 days, 14 days, and 21 days
 STATISTICAL ANALYSIS

The data so obtained were subjected to statistical analysis

using ANOVA, Paired “t”, and Unpaired t-test
 RESULT
Mean values of fluoride ion release (ppm) and pH change from
different subgroups at 7, 14, and 21 days
Days Parameter GN GA CSN CSA CLN CLA
7 ppm 4.56 5.11 2.88 7.94 2.55 6.45
pH change +0.03 +0.39 +0.03 +1.44 +0.01 +0.97
14 ppm 2.08 5.13 0.73 7.84 0.98 5.30
pH change +0.03 +0.81 +0.01 +0.98 +0.01 +0.21
21 ppm 1.49 5.64 1.49 7.14 0.48 4.77
pH change +0.04 +0.19 +0.04 +0.51 +0.05 +0.14
 Probable values of paired t-test between subgroups of Groups G, CS,
and CL for fluoride ion release and pH change
Time Parameter Probable values of paired t-test in subgroups for fluoride ion
points release and pH change
(days) GN GA CSN CSA CLN CLA

7-14 ppm 0.0000* 0.9292 0.0000* 0.5784 0.0000* 0.0000*

pH 0.8934 0.0000* 0.3243 0.0000* 0.0608 0.0000*
7-21 ppm 0.0000* 0.0190* 0.008* 0.0004* 0.0000* 0.0000*
pH 0.7892 0.0098* 0.4653 0.0003* 0.0850 0.0000*
14-21 ppm 0.1677 0.0040* 0.0391* 0.0321* 0.0001* 0.0036*

pH

0.7543 0.0013* 0.2534 0.0028* 0.1201 0.2143

A statistically significant difference at 0.05 level of significance (P<0.05)

 DISCUSSION

1. Mandibular molars were selected for the sample

preparation
2. An attempt was made to eliminate any kind of bias
3. Deionized water was preferred as the storage medium
over artificial saliva
4. The storage medium was changed in every 24 hr
RESULTS-
1. This study showed a higher amount of fluoride ion release in acidic pH as
compared to neutral pH in all the groups
2. In neutral pH, GIC released significantly higher amounts of fluoride ion
when compared to Cention-N (self-cure and light-cure) at all time intervals
3. In acidic pH, Cention-N (self-cure) released significantly higher amounts of
fluoride ion when compared to GIC at all time intervals.
4. Cention-N demonstrated a significantly higher alkalizing potential in acidic
pH as compared to GIC
5. Cention-N in self-cure mode released significantly higher fluoride ions and
exhibited greater alkalizing ability as compared to that of light-cure mode
 CONCLUSION

Within the limitations of the study, the following conclusions were formulated –
1)The highest fluoride ion release potential was exhibited by Cention-N (self-
cure) in acidic medium and GIC in neutral medium.
2)Fluoride ion release was higher in acidic pH as compared to neutral pH for
both Cention-N and GIC.
3)Fluoride ion release decreased over the period in both acidic and neutral pH in
all the groups except GIC (in acidic medium), where the fluoride ion release
gradually increased over the period.
4) All the groups demonstrated alkalizing ability in acidic medium with Cention-
N (self-cure) having significantly higher alkalizing potential than Cention-N (light-
cure) and the lowest being in GIC.
 A Comparative Evaluation of Mechanical
Properties of Four Different Restorative Materials:
An In Vitro Study

Nahid Iftikhar, Devashish, Binita Srivastava, Nidhi Gupta

International Journal of Clinical Pediatric Dentistry
(2019)
 AIM

To compare the mechanical properties (compressive strength

(CS) and diametral tensile strength (DTS)) of four different
restorative materials: conventional glass ionomer (Fuji IX),
ClearFil AP-X, Filtex Z350-XT, and Cention N.
 METHOD

• A total of 80 specimens (n = 80) were prepared with the following

four materials
Table 1: The restorative materials tested in this study
M a te ri a l s M a n u fa ctu re rs
G I C (Fuj i I X ) G C C orp. , Japan
Cl e arFi l A P-X Kuraray
Fi l t ex Z350-XT 3M ESPE
C enti on N Ivoclar Vivadent
• A total of 40 specimens were used for testing compressive strength and
the remaining 40 were used for the diametral tensile strength (DTS)
testing.
• The specimens were prepared in cylindrical molds with standard
dimensions as recommended by the ADA
• For this, all the materials were manipulated according to manufacturer’s
instructions at room temperature 23 °C and relative humidity of 40 -
60%. The mixed material was slowly inserted in the molds and plates
were placed above it followed by slight application of pressure for 20
seconds. The excess material was then extruded from the top.
• The test specimens were kept in a water bath at 37 ± 1°C for 1 hour
before testing.
Compressive Strength Testing
• Cylindrical specimens were prepared in molds with dimensions of 6
mm in diameter and 12 mm in height
• The test was carried out using the
Instron universal testing machine
that has a crosshead speed of 1.0
mm/minute.
• Each sample was placed with the flat
ends between the platens of the
machine. The maximum load applied
to fracture the specimens was
recorded and the compressive
strength was calculated using the
following formula: CS = 4P/πD2
DTS Testing
• The dimension of specimens was 6.0 mm in diameter and
3.0 mm in height.
• The sample was placed with the flat ends perpendicular to
the platens of the machine such that the load will be
applied to the diameter of the specimen.
• The maximum load applied to fracture the specimens was
recorded and the DTS was calculated using the following
formula: T = 2P/πDL
 Statistical Analysis

Statistical analysis of compressive strength and DTS testing was

performed and the mean value with its standard deviation was
calculated for each restorative material. Results were subjected to
one-way ANOVA for comparison between groups and Tukey’s post
hoc test to compare the materials among groups.
p < 0.0001 was obtained which indicates a highly statistically
significant difference between tested materials.
RESULTS
Compressive strength of restorative materials tested
MATERIAL Compressive strength
GIC 47 ± 10
ClearFil AP-X 134 ± 26
Filtex Z350-XT 126 ± 19
Cention N 121 ± 33
: DTS of restorative materials tested
MATERIAL DTS
GIC 11.8 ± 2.3
ClearFil AP-X 46.4 ± 17.5
Filtex Z350-XT 42.3 ± 28.4
Cention N 41 ±15.3
 Discussion

• Compressive and DTS was evaluated

• Cention N and Filtex XT were compared and evaluated
• Results-
1. Filtex XT did not perform as well as Clearfil
2. Cention N also did not perform as well as Clearfil
3. GIC as expected performed the poorest
 Conclusion
The micro-hybrid composite ClearFil AP-X has the highest
compressive strength and DTS and the properties of
Filtex Z350-XT and Cention N were almost similar but GIC
(Fuji IX) exhibited the least values when compared with
that of the other materials