Bulk Fill Resin Composites in Restorative Dentistry: A Review Article of In Vivo Studies

Yıl 2025, Cilt: 7 Sayı: 3, 175 - 185, 28.10.2025

Gülşah Yenier Yurdagüven

Öz

Bulk fill resin composites (BFRCs) were developed to simplify restorative procedures and overcome the limitations of the incremental approach. Applicable in thicknesses of 4–5 mm, they reduce working time while providing satisfactory mechanical and clinical performance. This review article synthesizes in vivo evidence from the last decade on posterior teeth, focusing on the retention, marginal adaptation, marginal discoloration, postoperative sensitivity, and secondary caries of BFRC restorations. The findings indicate that BFRCs exhibit comparable annual failure rates and retention to composite resins placed incrementally. While marginal discoloration increased over time, no significant differences in marginal integrity were identified. Flowable BFRCs provided superior cavity adaptation, whereas high-viscosity variants offered enhanced mechanical strength. Advancements such as sonic activation and thermo-viscous systems have contributed to improved viscosity and cavity adaptation. Overall, BFRCs represent a clinically reliable material, offering efficiency and acceptable longevity in restorative dentistry.

Anahtar Kelimeler

Bulk fill resin composite , Clinical trials , Resin composite , Marginal discoloration , Retention

Etik Beyan

Non applicable

Destekleyen Kurum

Non applicable

Proje Numarası

Yok

Teşekkür

Non applicable

Restoratif Diş Hekimliğinde Bulk Fill Rezin Kompozitler: İn Vivo Çalışmalar Üzerine Bir Derleme Makale

Öz

Bulk fill rezin kompozitler (BFRK), restoratif prosedürleri kolaylaştırmak ve tabakalı yerleştirme yaklaşımının teknik hassasiyetini azaltmak amacıyla geliştirilmiştir. 4–5 mm kalınlıkta uygulanabilmeleri işlem süresini kısaltırken yeterli mekanik ve klinik performans sağlamaktadır. Bu derleme, son on yılda yayımlanan klinik çalışmaları inceleyerek posterior dişlerdeki BFRK restorasyonlarının retansiyon, kenar adaptasyonu, kenar renkleşmesi, postoperatif hassasiyet ve sekonder çürük kriterlerini değerlendirmektedir. Bulgular, BFRK’lerin geleneksel kompozitlerle benzer yıllık başarısızlık oranları ve retansiyon yüzdeleri gösterdiğini ortaya koymaktadır. Zamanla kenar renkleşmesi artsa da kenar bütünlüğü açısından anlamlı farklılık bulunmamaktadır. Akışkan BFRK’ ler kaviteye daha iyi adaptasyon, yüksek viskoziteli BFRK’ ler ise daha yüksek mekanik dayanım sunmaktadır. Sonik aktivasyon ve termo-viskoz sistem BFRK uygulamaları gibi yenilikler, materyallerin viskozitesini ve kaviteye adaptasyonunu daha da geliştirmiştir. Genel olarak, BFRK’ ler işlem süresini kısaltmaları ve kabul edilebilir uzun dönem performanslarıyla restoratif diş hekimliğinde güvenilir materyaller olarak öne çıkmaktadır.

Anahtar Kelimeler

Bulk fill rezin kompozit , Klinik çalışma , Kompozit rezin , Kenar renkleşmesi , Retansiyon

Etik Beyan

Yok

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Yok

Kaynakça

• 1. Hirata R, Kabbach W, De Andrade OS, Bonfante EA, Giannini M, Coelho PG. Bulk fill composites: an anatomic sculpting technique. Journal of Esthetic and Restorative Dentistry. 2015;27(6):335-343.
• 2. Lutz EKI, Oldenburg TR. Elimination of polymerization stresses at the margins of posterior composite resin restorations: a new restorative technique. Quintessence Int. 1986;17:777–84.
• 3. Braga RR, Ballester RY, Ferracane JL. Factors involved in the development of polymerization shrinkage stress in resin-composites: a systematic review. Dent Mater. 2005;21:962–70.
• 4. Corral-Núnez C, Vildósola-Grez P, Bersezio-Miranda C, et al. Sate of the art of bulk-fill resin-based composites: a review. Revista Facultad de Odontología Universidad de Antioquia. 2015;27:177–196.
• 5. Carvalho RM, Pereira JC, Yoshiyama M, Pashley DH. A review of polymerization contraction: the influence of stress development versus stress relief. Oper Dent. 1996;21:17–24
• 6. Van Ende A, De Munck J, Lise DP, et al. Bulk-Fill composites: a review of the current literature. J Adhes Dent. 2017;19(2):95–109.
• 7. Ilie N, Schöner C, Bücher K, Hickel R. An in-vitro assessment of the shear bond strength of bulk-fill resin composites to permanent and deciduous teeth. J Dent. 2014;42(7):850–855.
• 8. Fronza BM, Rueggeberg FA, Braga RR, Mogilevych B, Soares LES, Martin AA, et al. Monomer conversion, microhardness, internal marginal adaptation, and shrinkage stress of bulk-fill resin composites. Dent Mater. 2015;31(12):1542–1551.
• 9. Tomaszewska IM, Kearns JO, Ilie N, Fleming GJ. Bulk fill restoratives: to cap or not to cap–that is the question? J Dent. 2015;43(3):309–16.
• 10. Fugolin APP, Pfeifer CS. New resins for dental composites. Journal of Dental Research. 2017;96(10):1085-1091.
• 11. Silva G, Marto CM, Amaro I, Coelho A, Sousa J, Ferreira MM, et al. Bulk-fill resins versus conventional resins: an umbrella review. Polymers. 2023;15(12):2613.
• 12. Rego GF, Schneider LFJ, Vianna-de-Pinho MG, Vidal ML, Alonso RCB, Cavalcante LM. Clinical time required and internal adaptation in cavities restored with bulk-fill composites. The Journal of Contemporary Dental Practice. 2017;18:1107-1111.
• 13. Tardem C, Albuquerque EG, Lopes LDS, Marins SS, Calazans FS, Poubel LA, et al. Clinical time and postoperative sensitivity after use of bulk-fill (syringe and capsule) vs. incremental filling composites: a randomized clinical trial. Brazilian Oral Research. 2019;33:e089.
• 14. Sampaio CS, Arias JF, Atria PJ, Cáceres E, Díaz CP, Freitas AZ, et al. Volumetric polymerization shrinkage and its comparison to internal adaptation in bulk fill and conventional composites: A μCT and OCT in vitro analysis. Dental Materials. 2019;35(11):1568-1575.
• 15. Soares CJ, Rosatto CMP, Carvalho VF, Bicalho AA, Henriques JCG, Faria-e-Silva AL. Radiopacity and porosity of bulk-fill and conventional composite posterior restorations—digital X-ray analysis. Operative Dentistry. 2017;42(6):616-625.
• 16. Alshali RZ, Silikas N, Satterthwaite JD. Degree of conversion of bulk-fill compared to conventional resincomposites at two time intervals. Dental Materials 2013;29(9):e213-e217.
• 17. Czasch P, Ilie N. In vitro comparison of mechanical properties and degree of cure of bulk fill composites. Clinical Oral Investigations. 2013;17(1):227-235.
• 18. David C, Cuevas-Suárez CE, de Cardoso GC, Isolan CP, de Moraes RR, da Rosa WLO, et al. Characterization of contemporary conventional, bulk-fill, and self-adhesive resin composite materials. Operative Dentistry. 2022;47(4):392-402.
• 19. de Araújo-Neto VG, Sebold M, de Castro EF, Feitosa VP, Giannini M. Evaluation of physico-mechanical properties and filler particles characterization of conventional, bulk-fill, and bioactive resin-based composites. Journal of The Mechanical Behavior of Biomedical Materials. 2021;115,104288.
• 20. Leprince JG, Palin WM, Vanacker J, Sabbagh J, Devaux J, Leloup G. Physico-mechanical characteristics of commercially available bulk-fill composites. Journal of Dentistry. 2014;42(8):993-1000.
• 21. Endo Hoshino IA, Fraga Briso AL, Bueno Esteves LM, Dos Santos PH, Meira Borghi Frascino S, Fagundes TC. Randomized prospective clinical trial of class II restorations using flowable bulk-fill resin composites: 4-year follow-up. Clinical Oral Investigations. 2022;26(9):5697-5710.
• 22. Van Dijken JW, Pallesen U. Bulk‐filled posterior resin restorations based on stress‐decreasing resin technology: a randomized, controlled 6‐year evaluation. European Journal of Oral Sciences. 2017;125(4):303-309.
• 23. Yazici AR, Kutuk ZB, Ergin E, Karahan S, Antonson SA. Six-year clinical evaluation of bulk-fill and nanofill resin composite restorations. Clinical Oral Investigations. 2022;26(1):417-426.
• 24. Yazici AR, Tekce AU, Kutuk ZB. Comparative evaluation of different adhesive strategies of a universal adhesive in class II bulk-fill restorations: A 48-month randomized controlled trial. Journal of Dentistry. 2022;117:103921.
• 25. Oliveira VCA, Oliveira FPSLD, Magalhães CS, Oliveira FBSD, Marques IP, Noronha MDS, et al. Short-term effect of adhesive system on clinical performance of bulk fill composite: randomized clinical trial. Brazilian Journal of Oral Sciences. 2022;21:e225042.
• 26. Loguercio AD, Naupari-Villasante R, Gutierrez MF, Gonzalez MI, Reis A, Heintze SD. 5-year clinical performance of posterior bulk-filled resin composite restorations: a double-blind randomized controlled trial. Dental Materials. 2023;39(12):1159-1168.
• 27. Benetti AR, Havndrup-Pedersen C, Honoré D, Pedersen MK, Pallesen U. Bulk-fill resin composites: polymerization contraction, depth of cure, and gap formation. Operative Dentistry. 2015;40(2):190-200.
• 28. Fróes-Salgado NR, Silva LM, Kawano Y, Francci C, Reis A, Loguercio AD. Composite pre-heating: effects on marginal adaptation, degree of conversion and mechanical properties. Dental Materials. 2010;26(9):908-914.
• 29. Yang J, Silikas N, Watts DC. Pre-heating time and exposure duration: Effects on post-irradiation properties of a thermo-viscous resin-composite. Dental Materials. 2020;36(6):787-793.
• 30. Genaid TM. Clinical evaluation of thermo-viscous and sonic fill-activated bulk fill composite restorations. Am J Dentistry. 2023;36(2):81-85.
• 31. Goda B, Hamdi K, Eltoukhy RI, Ali AI, Mahmoud SH. Clinical performance of different bulk‐fill composite resin systems in class II cavities: A 2‐year randomized clinical trial. Journal of Esthetic and Restorative Dentistry. 2024;36(8):1122-1137.
• 32. Vildósola P, Nakouzi J, Rodriguez S, Reyes A, Reyes J, Conejeros C. Six-month follow-up of two Bulk-fill composites in non-carious cervical lesions: double blind randomized clinical trial. J Oral Res. 2019;8(8):210-219.
• 33. Canali GD, Ignácio SA, Rached RN, Souza EM. One-year clinical evaluation of bulk-fill flowable vs. regular nanofilled composite in non-carious cervical lesions. Clinical Oral Investigations. 2019;23(2):889-897.
• 34. Correia AMDO, Jurema ALB, Bresciani E, Caneppele TMF. Effects of lesion size on the 30-month clinical performance of restorations with bulk fill and a regular nanofilled resin composite in noncarious cervical lesions. Clinical Oral Investigations. 2023;27(6):3083-3093.
• 35. Favoreto MW, de Souza Carneiro T, Wendlinger M, Naupari-Villasante R, de Matos TP, Kunz P.M, et al. Various ways of pre-heating a bulk-fill thermoviscous composite in restoration in non-carious cervical lesions: 12-month randomized clinical trial. Clinical Oral Investigations. 2023;27(8):4345-4359.
• 36. Guarneri JAG, Maucoski C, Ghaffari S, Macneil BD, Price RB, Arrais CAG. Ability of a novel primer to enhance the polymerization of a self-cured resin composite. Dental Materials. 2025;41(1):42-50.
• 37. Loguercio A, Carpio-Salvatierra B, Ñaupari-Villasante R, Armas-Vega A, Cavagnaro S, León A, et al. Clinical Evaluation of a New Chemically-Cured Bulk-Fill Composite in Posterior Restorations: 18-Month Multicenter Double-Blind Randomized Clinical Trial. Journal of Dentistry. 2025;106031.
• 38. Arbildo-Vega HI, Lapinska B, Panda S, Lamas-Lara C, Khan AS, Lukomska-Szymanska M. Clinical effectiveness of bulk-fill and conventional resin composite restorations: systematic review and meta-analysis. Polymers. 2020;12(8):1786.
• 39. Reis A, Loguercio AD, Schroeder M, Luque-Martinez I, Masterson D, Cople Maia L. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations? A systematic review and meta-analysis Dental Materials. 2015;31(9):1052-1067.
• 40. Costa TRF, Rezende M, Sakamoto A, Bittencourt B, Dalzochio P, Loguercio AD, et al. Influence of adhesive type and placement technique on postoperative sensitivity in posterior composite restorations. Operative Dentistry. 2017;42(2):143-154.
• 41. Hickel R, Peschke A, Tyas M, Mjor I, Bayne S, Peters M, et al. FDI world dental federation—Clinical criteria for the evaluation of direct and indirect restorations. Update and clinical examples. J. Adhes. Dent. 2010;12:259–272.
• 42. Göstemeyer G, Blunck U, Paris S, Schwendicke F. Design and validity of randomized controlled dental restorative trials. Materials. 2016;9(5):372.
• 43. Arbildo-Vega HI, Lapinska B, Panda S, Lamas-Lara C, Khan AS, Lukomska-Szymanska M. Clinical effectiveness of bulk-fill and conventional resin composite restorations: systematic review and meta-analysis. Polymers. 2020;12(8):1786.