Skip to main content

Advertisement

SpringerLink
Log in

Is the clinical performance of composite resin restorations in posterior teeth similar if restored with incremental or bulk-filling techniques? A systematic review and meta-analysis

  • Review
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

A systematic review was performed to analyze the clinical performance of class I and II restorations in posterior teeth placed with the incremental or the bulk-filling techniques. The primary outcome was retention/fracture rate, and the secondary outcomes evaluated were anatomical form, surface texture, color match, marginal adaption, marginal discoloration, caries, and postoperative sensitivity.

Methods

Electronic and manual searches were performed for randomized clinical trials comparing the clinical performance of composite resin restorations in posterior teeth placed with the incremental or the bulk-filling techniques. The Cochrane Collaboration risk of bias tool was used to assess the quality of the studies and the GRADE tool was used to access the quality of the evidence.

Results

Fourteen studies were included in this systematic review and most of them had unclear risk of bias. The risk difference (RD) for retention/fracture was 0.00 (95%CI =  − 0.01, 0.01; p = 0.86) for 1–1.5 years of follow-up; 0.00 (95%CI =  − 0.02, 0.02; p = 0.88) for 2–3 years of follow-up; 0.05 (95%CI =  − 0.08, 0.18; p = 0.46) for 5 or more years of follow-up. The RD for postoperative sensitivity was 0.04 (95%CI =  − 0.02, 0.10; p = 0.18) for up to 30 days; 0.00 (95%CI =  − 0.01, 0.02; p = 0.63) for 1–1.5 years of follow-up; and 0.00 (95%CI =  − 0.01, 0.02; p = 0.71) for 2–3 years of follow-up. For the other secondary outcomes, no significant differences were observed (p > 0.05) between the restorative techniques. The certainty of evidence was graded as moderate.

Conclusions

The clinical performance of class I and II restorations in posterior teeth is similar when placed with the incremental and bulk-filling techniques.

Clinical relevance: Based on the results of this study, posterior restorations placed with bulk-filling technique present satisfactory clinical performance, which is similar to direct restorations placed with the conventional incremental technique, considering various follow-up periods evaluated.

Trial registration: CRD42018108450.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Alzraikat H, Burrow MF, Maghaireh GA, Taha NA (2018) Nanofilled resin composite properties and clinical performance: a review. Oper Dent 43:E173–E190. https://doi.org/10.2341/17-208-T

    Article  PubMed  Google Scholar 

  2. Braga RR, Ballester RY, Ferracane JL (2005) Factors involved in the development of polymerization shrinkage stress in resin-composites: a systematic review. Dent Mater 21:962–970. https://doi.org/10.1016/j.dental.2005.04.018

    Article  PubMed  Google Scholar 

  3. Giachetti L, Scaminaci Russo D, Bambi C, Grandini R (2006) A review of polymerization shrinkage stress: current techniques for posterior direct resin restorations. J Contemp Dent Pract 7:79–88

    Article  Google Scholar 

  4. Kaisarly D, Gezawi ME (2016) Polymerization shrinkage assessment of dental resin composites: a literature review. Odontology 104:257–270. https://doi.org/10.1007/s10266-016-0264-3

    Article  PubMed  Google Scholar 

  5. Mantri SP, Mantri SS (2013) Management of shrinkage stresses in direct restorative light-cured composites: a review. J Esthet Restor Dent 25:305–313. https://doi.org/10.1111/jerd.12047

    Article  PubMed  Google Scholar 

  6. Perdigao J, Swift EJ Jr (2013) Critical appraisal: post-op sensitivity with direct composite restorations. J Esthet Restor Dent 25:284–288. https://doi.org/10.1111/jerd.12045

    Article  PubMed  Google Scholar 

  7. Lopes GC, Baratieri LN, Monteiro S Jr, Vieira LC (2004) Effect of posterior resin composite placement technique on the resin-dentin interface formed in vivo. Quintessence Int 35:156–161

    PubMed  Google Scholar 

  8. Li X, Pongprueksa P, Van Meerbeek B, De Munck J (2015) Curing profile of bulk-fill resin-based composites. J Dent 43:664–672. https://doi.org/10.1016/j.jdent.2015.01.002

    Article  PubMed  Google Scholar 

  9. Fronza BM, Rueggeberg FA, Braga RR, Mogilevych B, Soares LE, Martin AA, Ambrosano G, Giannini M (2015) Monomer conversion, microhardness, internal marginal adaptation, and shrinkage stress of bulk-fill resin composites. Dent Mater 31:1542–1551. https://doi.org/10.1016/j.dental.2015.10.001

    Article  PubMed  Google Scholar 

  10. Miletic V, Pongprueksa P, De Munck J, Brooks NR, Van Meerbeek B (2017) Curing characteristics of flowable and sculptable bulk-fill composites. Clin Oral Investig 21:1201–1212. https://doi.org/10.1007/s00784-016-1894-0

    Article  PubMed  Google Scholar 

  11. Van Ende A, De Munck J, Lise DP, Van Meerbeek B (2017) Bulk-fill composites: a review of the current literature. J Adhes Dent 19:95–109. https://doi.org/10.3290/j.jad.a38141

    Article  PubMed  Google Scholar 

  12. Moher D, Liberati A, Tetzlaff J, Altman DG and Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535https://doi.org/10.1136/bmj.b2535

  13. Higgins JPT and Green S (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. In: Higgins JPT and Green S (eds) Book title. The Cochrane Collaboration,

  14. Paula AM, Boing TF, Wambier LM, Hanzen TA, Loguercio AD, Armas-Vega A, Reis A (2019) Clinical performance of non-carious cervical restorations restored with the “sandwich technique” and composite resin: a systematic review and meta-analysis. J Adhes Dent 21:497–508. https://doi.org/10.3290/j.jad.a43696

    Article  PubMed  Google Scholar 

  15. Dunbar T, Abuelyaman A, Dede K, Kittelson J, Craig B, Doruf M and Edgington J (2015) Adaptation of bulk fill composites in class II restorations. Book title., Boston, Massachusetts

  16. McGuirk C, Hussain F, Millar BJ (2017) Survival of direct posterior composites with and without a bulk fill base. Eur J Prosthodont Restor Dent 25:136–142. https://doi.org/10.1922/EJPRD_01670McGuirk07

    Article  PubMed  Google Scholar 

  17. Oter B, Deniz K, Cehreli SB (2018) Preliminary data on clinical performance of bulk-fill restorations in primary molars. Niger J Clin Pract 21:1484–1491. https://doi.org/10.4103/njcp.njcp_151_18

    Article  PubMed  Google Scholar 

  18. Arhun N, Celik C, Yamanel K (2010) Clinical evaluation of resin-based composites in posterior restorations: two-year results. Oper Dent 35:397–404. https://doi.org/10.2341/09-345-C

    Article  PubMed  Google Scholar 

  19. Alkurdi R, Abboud S (2016) Clinical evaluation of class II composite: resin restorations placed by two different bulk-fill techniques. Journal of Orofacial Sciences 8:34–39. https://doi.org/10.4103/0975-8844.181926

    Article  Google Scholar 

  20. Atabek D, Aktas N, Sakaryali D, Bani M (2017) Two-year clinical performance of sonic-resin placement system in posterior restorations. Quintessence Int 48:743–751. https://doi.org/10.3290/j.qi.a38855

    Article  PubMed  Google Scholar 

  21. Balkaya H, Arslan S (2020) A two-year clinical comparison of three different restorative materials in class II cavities. Oper Dent 45:E32–E42. https://doi.org/10.2341/19-078-C

    Article  PubMed  Google Scholar 

  22. Balkaya H, Arslan S and Pala K (2019) A randomized, prospective clinical study evaluating effectsiveness of a bulk-fill composite resin, a conventional composite resin and a reinforced glass ionomer in class II cavities: one-year results. J Appl Oral Sci 27:e20180678https://doi.org/10.1590/1678-7757-2018-0678

  23. Bayraktar Y, Ercan E, Hamidi MM and Colak H (2017) One-year clinical evaluation of different types of bulk-fill composites. J Investig Clin Dent 8. https://doi.org/10.1111/jicd.12210

  24. Colak H, Tokay U, Uzgur R, Hamidi MM, Ercan E (2017) A prospective, randomized, double-blind clinical trial of one nano-hybrid and one high-viscosity bulk-fill composite restorative systems in class II cavities: 12 months results. Niger J Clin Pract 20:822–831. https://doi.org/10.4103/1119-3077.212449

    Article  PubMed  Google Scholar 

  25. Costa T, Rezende M, Sakamoto A, Bittencourt B, Dalzochio P, Loguercio AD, Reis A (2017) Influence of adhesive type and placement technique on postoperative sensitivity in posterior composite restorations. Oper Dent 42:143–154. https://doi.org/10.2341/16-010-C

    Article  PubMed  Google Scholar 

  26. Frascino S, Fagundes TC, Silva U, Rahal V, Barboza A, Santos PH, Briso A (2020) Randomized prospective clinical trial of class II restorations using low-shrinkage flowable resin composite. Oper Dent 45:19–29. https://doi.org/10.2341/18-230-C

    Article  PubMed  Google Scholar 

  27. Heck K, Manhart J, Hickel R, Diegritz C (2018) Clinical evaluation of the bulk fill composite QuiXfil in molar class I and II cavities: 10-year results of a RCT. Dent Mater 34:e138–e147. https://doi.org/10.1016/j.dental.2018.03.023

    Article  PubMed  Google Scholar 

  28. Hickey D, Sharif O, Janjua F, Brunton PA (2016) Bulk dentine replacement versus incrementally placed resin composite: a randomised controlled clinical trial. J Dent 46:18–22. https://doi.org/10.1016/j.jdent.2016.01.011

    Article  PubMed  Google Scholar 

  29. Karaman E, Keskin B, Inan U (2017) Three-year clinical evaluation of class II posterior composite restorations placed with different techniques and flowable composite linings in endodontically treated teeth. Clin Oral Investig 21:709–716. https://doi.org/10.1007/s00784-016-1940-y

    Article  PubMed  Google Scholar 

  30. Loguercio AD, Rezende M, Gutierrez MF, Costa TF, Armas-Vega A, Reis A (2019) Randomized 36-month follow-up of posterior bulk-filled resin composite restorations. J Dent 85:93–102. https://doi.org/10.1016/j.jdent.2019.05.018

    Article  PubMed  Google Scholar 

  31. Manhart J, Chen HY, Hickel R (2009) Three-year results of a randomized controlled clinical trial of the posterior composite QuiXfil in class I and II cavities. Clin Oral Investig 13:301–307. https://doi.org/10.1007/s00784-008-0233-5

    Article  PubMed  Google Scholar 

  32. Manhart J, Chen HY, Hickel R (2010) Clinical evaluation of the posterior composite Quixfil in class I and II cavities: 4-year follow-up of a randomized controlled trial. J Adhes Dent 12:237–243. https://doi.org/10.3290/j.jad.a17551

    Article  PubMed  Google Scholar 

  33. Manhart J, Chen HY, Neuerer P, Thiele L, Jaensch B, Hickel R (2008) Clinical performance of the posterior composite QuiXfil after 3, 6, and 18 months in class 1 and 2 cavities. Quintessence Int 39:757–765

    PubMed  Google Scholar 

  34. Tardem C, Albuquerque EG, Lopes LS, Marins SS, Calazans FS, Poubel LA, Barcelos R and Barceleiro MO (2019) Clinical time and postoperative sensitivity after use of bulk-fill (syringe and capsule) vs. incremental filling composites: a randomized clinical trial. Braz Oral Res 33:e089. doi: https://doi.org/10.1590/1807-3107bor-2019.vol33.0089

  35. van Dijken JW, Pallesen U (2014) A randomized controlled three year evaluation of “bulk-filled” posterior resin restorations based on stress decreasing resin technology. Dent Mater 30:e245-251. https://doi.org/10.1016/j.dental.2014.05.028

    Article  PubMed  Google Scholar 

  36. van Dijken JW, Pallesen U (2015) Randomized 3-year clinical evaluation of class I and II posterior resin restorations placed with a bulk-fill resin composite and a one-step self-etching adhesive. J Adhes Dent 17:81–88. https://doi.org/10.3290/j.jad.a33502

    Article  PubMed  Google Scholar 

  37. van Dijken JW, Pallesen U (2016) Posterior bulk-filled resin composite restorations: a 5-year randomized controlled clinical study. J Dent 51:29–35. https://doi.org/10.1016/j.jdent.2016.05.008

    Article  PubMed  Google Scholar 

  38. van Dijken JWV, Pallesen U (2017) Bulk-filled posterior resin restorations based on stress-decreasing resin technology: a randomized, controlled 6-year evaluation. Eur J Oral Sci 125:303–309. https://doi.org/10.1111/eos.12351

    Article  PubMed  Google Scholar 

  39. Yazici AR, Antonson SA, Kutuk ZB, Ergin E (2017) Thirty-six-month clinical comparison of bulk fill and nanofill composite restorations. Oper Dent 42:478–485. https://doi.org/10.2341/16-220-C

    Article  PubMed  Google Scholar 

  40. Lima RBW, Troconis CCM, Moreno MBP, Murillo-Gomez F, De Goes MF (2018) Depth of cure of bulk fill resin composites: a systematic review. J Esthet Restor Dent 30:492–501. https://doi.org/10.1111/jerd.12394

    Article  PubMed  Google Scholar 

  41. Price RB, Ferracane JL, Hickel R, Sullivan B (2020) The light-curing unit: an essential piece of dental equipment. Int Dent J 70:407–417. https://doi.org/10.1111/idj.12582

    Article  PubMed  Google Scholar 

  42. Shimokawa C, Turbino ML, Giannini M, Braga RR, Price RB (2020) Effect of curing light and exposure time on the polymerization of bulk-fill resin-based composites in molar teeth. Oper Dent 45:E141–E155. https://doi.org/10.2341/19-126-L

    Article  PubMed  Google Scholar 

  43. Bucuta S, Ilie N (2014) Light transmittance and micro-mechanical properties of bulk fill vs. conventional resin based composites. Clin Oral Investig 18:1991–2000. https://doi.org/10.1007/s00784-013-1177-y

    Article  PubMed  Google Scholar 

  44. Miao C, Yang X, Wong MC, Zou J, Zhou X, Li C and Wang Y (2021) Rubber dam isolation for restorative treatment in dental patients. Cochrane Database Syst Rev 5:CD009858. doi: https://doi.org/10.1002/14651858.CD009858.pub3

  45. Wang Y, Li C, Yuan H, Wong MC, Zou J, Shi Z and Zhou X (2016) Rubber dam isolation for restorative treatment in dental patients. Cochrane Database Syst Rev 9:CD009858. doi: https://doi.org/10.1002/14651858.CD009858.pub2

  46. Dreweck FDS, Burey A, de Oliveira DM, Loguercio AD, Reis A (2021) Adhesive strategies in cervical lesions: systematic review and a network meta-analysis of randomized controlled trials. Clin Oral Investig 25:2495–2510. https://doi.org/10.1007/s00784-021-03844-5

    Article  PubMed  Google Scholar 

  47. Reis A, Dourado Loguercio A, Schroeder M, Luque-Martinez I, Masterson D, Cople Maia L (2015) Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?: a systematic review and meta-analysis. Dent Mater 31:1052–1067. https://doi.org/10.1016/j.dental.2015.06.001

    Article  PubMed  Google Scholar 

  48. Schroeder M, Correa IC, Bauer J, Loguercio AD, Reis A (2017) Influence of adhesive strategy on clinical parameters in cervical restorations: a systematic review and meta-analysis. J Dent 62:36–53. https://doi.org/10.1016/j.jdent.2017.05.006

    Article  PubMed  Google Scholar 

  49. Bayne SC, Schmalz G (2005) Reprinting the classic article on USPHS evaluation methods for measuring the clinical research performance of restorative materials. Clin Oral Investig 9:209–214. https://doi.org/10.1007/s00784-005-0017-0

    Article  PubMed  Google Scholar 

  50. Gostemeyer G, Blunck U, Paris S and Schwendicke F (2016) Design and validity of randomized controlled dental restorative trials. Materials (Basel) 9.https://doi.org/10.3390/ma9050372

  51. Hickel R, Peschke A, Tyas M, Mjor I, Bayne S, Peters M, Hiller KA, Randall R, Vanherle G, Heintze SD (2010) FDI World Dental Federation - clinical criteria for the evaluation of direct and indirect restorations. Update and clinical examples. J Adhes Dent 12:259–272. https://doi.org/10.3290/j.jad.a19262

    Article  PubMed  Google Scholar 

  52. Veloso SRM, Lemos CAA, de Moraes SLD, do Egito Vasconcelos BC, Pellizzer EP and de Melo Monteiro GQ, (2019) Clinical performance of bulk-fill and conventional resin composite restorations in posterior teeth: a systematic review and meta-analysis. Clin Oral Investig 23:221–233. https://doi.org/10.1007/s00784-018-2429-7

    Article  PubMed  Google Scholar 

  53. Cidreira Boaro LC, Pereira Lopes D, de Souza ASC, Lie Nakano E, Ayala Perez MD, Pfeifer CS, Goncalves F (2019) Clinical performance and chemical-physical properties of bulk fill composites resin -a systematic review and meta-analysis. Dent Mater 35:e249–e264. https://doi.org/10.1016/j.dental.2019.07.007

    Article  PubMed  Google Scholar 

  54. Borenstein M, Hedges LV, Higgins JP, Rothstein HR (2010) A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods 1:97–111. https://doi.org/10.1002/jrsm.12

    Article  PubMed  Google Scholar 

  55. Kim HY (2017) Statistical notes for clinical researchers: risk difference, risk ratio, and odds ratio. Restor Dent Endod 42:72–76. https://doi.org/10.5395/rde.2017.42.1.72

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The present study was funded by the authors’ own institution.

Author information

Authors and Affiliations

  1. School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Rua Prof. Pedro Viriato Parigot de Souza, 5300, Curitiba, PR, 81280-330, Brazil

    Patrícia Valéria Manozzo Kunz, Letícia Maíra Wambier, Marina da Rosa Kaizer, Gisele Maria Correr & Carla Castiglia Gonzaga

  2. Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Ponta Grossa, PR, 84030-900, Brazil

    Alessandra Reis

Authors
  1. Patrícia Valéria Manozzo Kunz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Letícia Maíra Wambier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marina da Rosa Kaizer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gisele Maria Correr
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alessandra Reis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carla Castiglia Gonzaga
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Patrícia Valéria Manozzo Kunz: data curation; formal analysis; methodology; writing—original draft.

Letícia Maíra Wambier: formal analysis; methodology; writing—review and editing.

Marina da Rosa Kaizer: formal analysis; writing—review and editing.

Gisele Maria Correr: formal analysis; methodology; writing—review and editing.

Alessandra Reis: formal analysis; methodology; writing—review and editing.

Carla Castiglia Gonzaga: conceptualization; methodology; project administration; supervision; validation; writing—review and editing.

Corresponding author

Correspondence to Carla Castiglia Gonzaga.

Ethics declarations

Ethics approval

This research did not involve human participants.

Informed consent

This research did not involve human participants.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kunz, P.V.M., Wambier, L.M., Kaizer, M.d. et al. Is the clinical performance of composite resin restorations in posterior teeth similar if restored with incremental or bulk-filling techniques? A systematic review and meta-analysis. Clin Oral Invest 26, 2281–2297 (2022). https://doi.org/10.1007/s00784-021-04337-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-021-04337-1

Keywords

Search

Navigation