Effects of Cention N® restorations on buccal cytogenotoxicity and salivary oxidative stress in children with dental caries

Cention N ® is an alkasite-based restorative dental material containing methacrylate monomers and ion‑releasing alkaline fillers that liberate calcium and fluoride, components that have been implicated in oxidative stress (OS) and potential DNA damage in oral epithelial tissues. This study evaluated buccal cytogenetic damage and OS associated with Cention N ® restorations in children, using the buccal micronucleus cytome assay for nuclear abnormalities (NAs) and salivary malondialdehyde (MDA) as a biomarker of oxidative stress. One hundred children were recruited, including 50 caries‑free controls and 50 caries‑affected subjects who received Cention N ® restorations. Buccal and attached gingival exfoliated cells and unstimulated whole saliva samples were collected at baseline and 30 days after treatment. Frequencies of NAs and salivary MDA concentrations were quantified and statistically compared between groups and time points. Children treated with Cention N ® showed a significant increase in both NAs frequency and salivary MDA levels 30 days after restoration ( p < 0.05), whereas controls did not exhibit significant changes. Salivary MDA levels correlated positively with NAs frequency ( p < 0.05), supporting an association between oxidative and genotoxic responses in oral epithelial cells. Short-term exposure to Cention N ® restorations in children was associated with higher NA frequencies in oral epithelial cells and increased salivary MDA levels, suggesting enhanced OS and buccal cytogenotoxic damage. Long‑term and mechanistic studies are warranted to determine the clinical relevance and persistence of these effects. The observed increases in NAs and MDA following Cention N ® restorations in children highlight the importance of carefully balancing restorative performance with potential biological effects when selecting materials for pediatric patients and underscore the central role of caries prevention in minimizing the need for restorative treatment.