Clinical and Laboratory Performance of ACTIVA BioACTIVE Restorative in Primary Teeth - A Systematic Review of Pediatric Evidence

Sep 30, 2026

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ACTIVA BioACTIVE Restorative is a resin–ionomer hybrid marketed for pediatric bioactive restorations, but its evidence in primary teeth has not been systematically synthesized. A PRISMA-aligned, OSF-registered review evaluated clinical and laboratory outcomes of ACTIVA in primary dentition versus established restorative materials. Searches covered PubMed, Scopus, and Web of Science up to 18 October 2025. Three randomized clinical trials and one in vitro study were included. Within 12–24 months, ACTIVA showed comparable clinical and radiographic performance to compomers, bulk-fill, and conventional composites, with shorter placement time and favorable calcium-ion release.

LanguageEnglish

CategoryResearch & Report

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Pages16

Reading Time40 min

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Abstract

Background and Objectives

Methods

Results

Conclusions

Introduction

Systematic Review Clinical and Laboratory Performance of ACTIVA BioACTIVE Restorative in Primary Teeth: A Systematic Review of Pediatric Evidence Malina Popa 1,†, Stefania Dinu 1,†, Magda Mihaela Luca 1,*, Bogdan Andrei Bumbu 2,*, Edita Maghet 3 and Romina Georgiana Bita 4 Academic Editor: Bruno Chrcanovic Received: 20 November 2025 Revised: 25 December 2025 Accepted: 1 January 2026 Published: 4 January 2026 Copyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Pediatric Dentistry Research Center (Pedo-Research), Department of Pediatric Dentistry, Faculty of Dental Medicine,“Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; [popa.malina@umft.ro](popa.malina@umft.ro) (M.P.); [dinu.stefania@umft.ro](dinu.stefania@umft.ro) (S.D.) 2 Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania 3 Faculty of Dental Medicine,“Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; [edita.maghet@umft.ro](edita.maghet@umft.ro) 4 Department II, Radiology and Medical Imaging, General and Dento-Maxillary Imaging, Faculty of Dental Medicine,“Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; romina.bita@umft.ro * Correspondence: [luca.magda@umft.ro](luca.magda@umft.ro) (M.M.L.); [bogdanbumbu@uoradea.ro](bogdanbumbu@uoradea.ro) (B.A.B.)† These authors contributed equally to this work. Abstract Background and Objectives: ACTIVA BioACTIVE Restorative is a resin–ionomer hybrid marketed as a bioactive material for pediatric restorations, yet its specific performance in primary teeth has not been systematically synthesized. The study aim was to evaluate clinical and laboratory outcomes of ACTIVA in primary dentition compared with established restorative materials. Methods: Following a PRISMA-aligned, OSF-registered protocol, PubMed, Scopus, and Web of Science were searched to 18 October 2025 for full-text clinical trials and in vitro studies involving ACTIVA in primary teeth or primary dentin. Eligible designs included randomized or prospective clinical studies and standardized in vitro experiments. Primary outcomes were clinical and radiographic success; secondary outcomes included placement time, shear bond strength, and calcium-ion release. Results: Three randomized clinical trials (86 children, 305 restorations) and one in vitro study met the inclusion criteria. At 12 months, clinical success with ACTIVA ranged from 97.5 to 97.8% versus 95.0–97.8% for bulk-fill and conventional composites. At 24 months, a splitmouth trial reported clinical success of 93.0% for ACTIVA and 95.3% for compomer, with radiographic success of 86.0% and 88.3%, respectively, remaining within the predefined non-inferiority margin. ACTIVA required a mean of 2.4 ± 0.6 min less placement time than compomer. In vitro, shear bond strength to primary dentin was higher for ACTIVA than for an RMGIC (4.29 ± 0.65 vs. 2.47 ± 0.32 MPa), with greater calcium-ion release at 21 days (0.77 ± 0.13 vs. 0.53 ± 0.12 ppm) . Conclusions: Within 1–2 years of follow-up, ACTIVA shows clinical performance in primary molars comparable to compomer, bulk-fill, and conventional composites, while offering shorter placement time and favorable biointeractive behavior. Keywords: dental caries; tooth; deciduous; composite resins; glass ionomer cements; calcium compounds 1. Introduction Dental caries in primary teeth remains one of the most common chronic conditions of childhood, with meta-analyses indicating that almost half of children worldwide have caries in their primary dentition and more than half in their permanent teeth [1] . Earlychildhood caries (ECC) is particularly pervasive, affecting a large proportion of pre

FAQs

What was the objective of this systematic review on ACTIVA BioACTIVE Restorative?

To evaluate clinical and laboratory outcomes of ACTIVA in primary dentition compared with established restorative materials, using a PRISMA-aligned, OSF-registered protocol.

Which outcomes were assessed in the included studies?

Primary outcomes included clinical and radiographic success. Secondary outcomes included placement time, shear bond strength, and calcium-ion release.

What did the review find about ACTIVA’s performance in primary teeth over 12–24 months?

ACTIVA showed clinical performance in primary molars comparable to compomers, bulk-fill, and conventional composites, while requiring shorter placement time; in vitro testing also showed higher shear bond strength and greater calcium-ion release.

Sep 30, 2026

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