Magister Chirurgiae Dentium (MChD) / Background: This study aimed to determine the association between dimensional change and surface roughness (Ra) of Vitremer, Activa and Cention N after immersing them into two different media: acidic and artificial saliva media for the period of a year. Measurements were made at 10 time intervals during the observation period. Methodology: This was a quantitative and qualitative study. For the quantitative part, a total of 60 specimens were tested, 20 specimens for each material. The 20 specimens were further divided into 10 specimens. Ten were immersed in acidic media and the rest in saliva media. A measurement of the weight, height, and Ra was carried out as follows: day 0, day 1, day 2, day 7, day 21, day 28, day 60, day 90, day 180 and day 365. Scanning electron microscopy (SEM) was used to examine the surface of each material qualitatively pre and post immersion in the two media. For fluoride measurements, an additional five samples from each material were left suspended in the de-ionized water by the use of dental floss. The materials were moved to new specimen jars after the completion of day 1, 2, 3, 4, 5, 6, 7, 14, 21 and 28. All the specimen jars had been kept for the fluoride measurements. Results: Non-parametric tests were used to analyze the data. Linear regression analysis was used to measure the association between weight, height or surface roughness (Ra) and immersion time for a year. The result of this test showed that Vitremer had a significant association between the weight (p = 0.000), height (p = 0.007) and Ra (p = 0.001) when it was immersed in acidic media. On the other hand, when Vitremer was immersed in saliva media, only the weight variable showed a significant association (p = 0.002). For Cention N, significant association was found for only Ra when immersed in acidic media (p = 0.000). Finally, for Activa, all the studied associations; the weight, height and Ra in both media were found to be insignificant. For saliva media, there was a significant weight change between the three materials during all 10 periods of time (p = 0.000). In the first six months, Cention N demonstrated a significant increase in weight changes followed by Vitremer, then Activa. Yet, after a year, the difference between Cention N and Vitremer became insignificant and Activa showed the least weight changes. There was not a significant difference between the materials in terms of height and Ra measurements. The fluoride experiment was not successful due to technical issues during pH measurements of the collected solutions. For comparison of the studied parameters between the three materials, the Kruskal-Wallis test was used. In acidic media, there was a significant difference between the materials in term of weight change in 10 periods of time (p = 0.000). In particular, after a two month period, Cention N had the highest weight, followed by Vitremer and then by Activa. The difference between Vitremer and Activa became insignificant throughout the rest of the experimental time frame. All the height measurements between the three materials were found to be insignificant except for day 365 (p = 0.048), where both Activa and Cention N were found to be significantly higher than Vitremer. For the Ra comparison, in the first two weeks, particularly day 1, 7 and 14, Cention N had significantly the lowest Ra among the other materials. As the three materials aged in the acidic media (day 180), Vitremer had significantly the highest Ra values. Cention N showed higher Ra values than Activa; nonetheless this difference was not significant. The SEM images showed loss of some particles in all post-experimental images of the materials in acidic media. Vitremer showed the widest cracks with the loss of fillers. In saliva media, there was also loss of particles but to a lesser extent than in acidic media. Yet, the post-experimental image of Activa in saliva resembled the pre-experimental one. Conclusion: Within the limitations of the study, the best material to resist Ra from prolonged acidic attack was Activa followed by Cention N and then Vitremer. Except for Vitremer, no significant changes in the Ra of the other materials were detected when the three materials were immersed in saliva media in the long term. In acidic media Vitremer tended to lose weight and height faster than Cention N and Activa over a year. Cention N is the best material to resist dimensional change. However, in artificial saliva Vitremer gained water rapidly. Activa did not absorb a lot of water and did not reject a lot of water; Activa demonstrated good dimensional stability and this property may be beneficial when compared to the other two materials tested. The clinical significance of the study: All the materials studied were subjected to dimensional and Ra changes following long-term exposure to acidic substances, but the newer materials (Cention N and Activa) seemed to be more dimensionally stable and resistant to Ra changes than the older, well-known material (Vitremer). This may influence a clinician’s choice of restorative material for use in pediatric dentistry.