Polymer-Infiltrated Ceramic Network Versus Smart Bioactive Self-Curing Composite for Cervical Restorations in Professional Ballet Dancers: A 24-Month Split-Mouth Randomized Controlled Trial

Background: and Objectives: Professional ballet dancers endure high occlusal loads, increasing cervical defect prevalence. Conventional composites fail frequently under such conditions. This randomized clinical trial (RCT) compared 24month performance of a polymerinfiltrated ceramic network (PICN, VITA Enamic) versus a selfcuring bioactive composite (Stela) for cervical restorations. Materials and Methods: Twenty professional ballet dancers (40 cervical defects: 21 carious, 19 abfraction) were enrolled in a splitmouth RCT. Each received one PICN inlay and one selfcuring composite restoration on two nonadjacent defects. Restorations were assessed at 6, 12, and 24 months using United States Public Health Service (USPHS) criteria (primary: marginal integrity) and a dye penetration test. Secondary outcomes included secondary caries, hypersensitivity, and Oral Health Impact Profile-14 (OHIP14). Statistical tests: McNemar, Fisher’s exact, Kaplan–Meier, logrank (α=0.05). Results: At 24 months, no PICN restoration failed (0%). Selfcuring composite failures were 20% (carious) and 30% (abfraction) (exploratory uncorrected p=0.031; nonsignificant after correction). Dye penetration was lower for PICN in abfraction defects (11% vs. 60%, adjusted p=0.048) but not in carious defects (9% vs. 30%, adjusted p=0.317). Kaplan–Meier survival favoured PICN (logrank p=0.001); 24month survival probability: PICN 100% (95% CI: 83–100%), selfcuring composite 75% (95% CI: 55–95%). No secondary caries or serious adverse events occurred. Conclusions: PICN hybrid ceramic provided superior marginal integrity and zero failures over 24 months in cervical restorations of professional ballet dancers, outperforming the selfcuring composite. PICN inlays are recommended for abfraction defects. The selfcuring composite may be considered for carious defects when light curing is problematic, but patients should be informed of higher failure risk. Longer studies are needed.