Clinical Oral Investigations

, Volume 23, Issue 1, pp 221–233 | Cite as

Clinical performance of bulk-fill and conventional resin composite restorations in posterior teeth: a systematic review and meta-analysis

  • Sirley Raiane Mamede Veloso
  • Cleidiel Aparecido Araújo Lemos
  • Sandra Lúcia Dantas de Moraes
  • Belmiro Cavalcanti do Egito Vasconcelos
  • Eduardo Piza Pellizzer
  • Gabriela Queiroz de Melo MonteiroEmail author
Original Article



The purpose of this systematic review was to compare the clinical performance of bulk-fill resin composites with conventional resin composites used for direct restorations of posterior teeth.


This review followed the PRISMA statement. This review was registered at PROSPERO (registration number CRD42016053436). A search of the scientific literature was performed by two independent reviewers using the PubMed/MEDLINE, Embase, The Cochrane Library, and Web of Science databases from commencement until January 2018. The research question was “Do bulk-fill resin composites have a clinical performance comparable to conventional resin composites in posterior restorations?” Only studies evaluating class I and II direct restorations in permanent teeth with a follow-up period of at least 1 year were included. The RevMan 5 program was used for meta-analysis, calculating the relative risk (RR) and 95% confidence interval (CI) of the dichotomous outcome (restoration failure or success).


Ten articles were selected, comprising 941 analyzed restorations. The mean follow-up period was 33.6 months (12–72 months). No statistically significant differences in the failure rate were observed between conventional and base/flowable bulk-fill resin composites (p = 0.31; RR 1.49; 95% CI 0.69–3.25) or full-body/sculptable bulk-fill resin composites (p = 0.12; RR 1.89; 95% CI 0.84–4.24).


The present systematic review and meta-analysis indicate similar clinical performances of bulk-fill and conventional resin composites over a follow-up period of 12 to 72 months.

Clinical significance

Based on the results of this study, the bulk-fill resin composites could be an alternative for direct restorations in posterior teeth. However, clinical trials of longer duration are required.


Dental restoration Direct restoration Resin composite Bulk-fill resin Incremental filling technique Systematic review 



The authors would like to thank CAPES (Coordination for the Improvement of Higher Education Personnel) for their financial support.


The work was supported by the CAPES (Coordination for the Improvement of Higher Education Personnel).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Sirley Raiane Mamede Veloso
    • 1
  • Cleidiel Aparecido Araújo Lemos
    • 2
  • Sandra Lúcia Dantas de Moraes
    • 1
  • Belmiro Cavalcanti do Egito Vasconcelos
    • 1
  • Eduardo Piza Pellizzer
    • 2
  • Gabriela Queiroz de Melo Monteiro
    • 1
    Email author
  1. 1.Dental SchoolUniversidade de Pernambuco/FOP-UPECamaragibeBrazil
  2. 2.Araçatuba Dental SchoolUNESP - Univ Estadual Paulista AraçatubaBrazil

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