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

Abstract

Objectives

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.

Methods

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).

Results

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).

Conclusions

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.

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Acknowledgements

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

Funding

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

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Correspondence to Gabriela Queiroz de Melo Monteiro.

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Veloso, S.R.M., Lemos, C.A.A., de Moraes, S.L.D. et al. Clinical performance of bulk-fill and conventional resin composite restorations in posterior teeth: a systematic review and meta-analysis. Clin Oral Invest 23, 221–233 (2019). https://doi.org/10.1007/s00784-018-2429-7

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  • DOI: https://doi.org/10.1007/s00784-018-2429-7

Keywords

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