ReviewCureus2026
Clinical Efficacy of Bioactive and Smart Restorative Materials in Preventing Secondary Caries: A Systematic Review and Meta-Analysis.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed.
- Cariogenic Risk Modifies the Effect of Marginal Adaptation on Caries Adjacent to Posterior Composite Restorations: A Stratified Multivariate Analysis.Clinics and practice · 2026Article
- Recent Advances in Caries Prevention and Non-Invasive Management: From Ecological Modulation to Precision Interventions.Dentistry journal · 2026Review
- Functional Adhesives for a Restorative Future.Journal of functional biomaterials · 2026Review
- Bioactive Fillers in Bulk-Fill Composite Resins: A Comprehensive Review of the Effects on Polymerization Shrinkage Behavior and Mechanical Performance.Materials (Basel, Switzerland) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Secondary caries is the primary cause of restoration failure, requiring the replacement of fillings and the progressive loss of tooth structure. Bioactive and smart restorative materials have been developed to combat this by releasing therapeutic ions (fluoride, calcium, phosphate) that promote remineralization and inhibit bacterial growth. However, clinical evidence regarding their efficacy compared with conventional inert materials remains fragmented. This systematic review and meta-analysis aimed to evaluate the clinical efficacy of bioactive restorative materials in preventing secondary caries compared with conventional restorative materials in permanent teeth. A systematic search was conducted across PubMed, Scopus, Web of Science, Embase, and CENTRAL for randomized controlled trials (RCTs) published up to 2025. Studies were included if they compared bioactive materials (glass ionomer cements (GICs), resin-modified glass ionomers (RMGICs), giomers, bioactive resins, alkasites) against conventional controls (resin composite, amalgam) in permanent teeth with a follow-up of ≥12 months. The primary outcome was the incidence of secondary caries. Risk of bias was assessed using the Cochrane RoB 2 tool. Data were synthesized using a random-effects meta-analysis with the Hartung-Knapp-Sidik-Jonkman adjustment. Trial sequential analysis (TSA) was performed to assess the conclusiveness of the evidence. Forty RCTs involving 5,506 restorations were included. The meta-analysis revealed that bioactive materials significantly reduced the risk of secondary caries by 45% compared with conventional materials (risk ratio (RR) = 0.55; 95% CI: 0.46 to 0.65; p < 0.001), with no statistical heterogeneity (I
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.