Alkasites in restorative dentistry: a review of their performance and properties.

OBJECTIVES: The limitations of traditional composite materials have highlighted the need for new classes of biologically active restorative materials. Among these are alkasites, which belong to the group of pH-responsive materials. The aim of this review is to summarize the body of evidence regarding alkasite performance, based on nearly a decade of use, since their introduction into practice. DATA: This review article includes in vitro and in vivo studies that explore the properties and performance of alkasites. SOURCES: Two reviewers conducted a search of literature published up to March 2025 in databases including PubMed, Web of Science and Scopus. STUDY SELECTION: The articles summarized and critically analyzed are primarily from journals with Q1 and Q2 quartiles. CONCLUSIONS: Various studies demonstrated that alkasites exhibit comparable or even superior physical and mechanical properties to the most commonly used restorative materials in dentistry. The materials' ability to withstand masticatory forces, combined with its favorable esthetic properties and bulk-fill method of application, make them a suitable option for restoring I, II and V class cavities in primary and permanent teeth. A significant advantage of the alkasites is that they can release hydroxide, calcium, and fluoride ions which may contribute to enamel and dentin remineralization. The release of hydroxyl ions might increase the pH in the surrounding environment, thus neutralizing the acidic medium created by cariogenic bacteria. This process helps inhibit demineralization and creates favorable conditions for remineralization. CLINICAL SIGNIFICANCE: The application of alkasites, particularly in caries-active patients, provides another alternative for restorative treatment of carious lesions. Analyzing their properties raises once again the question of improving the biological activity of restorative materials and the development of smart materials to meet the needs of conservative dental approach.