Microcomputed tomographic comparison of posterior composite resin restorative techniques: sonicated bulk fill versus incremental fill

Abstract

Sonication technology has recently been touted to decrease composite viscosity during delivery and may allow better cavity preparation adaptation and minimize voids. The purpose of this investigation was to evaluate the difference between conventional, hand-placed, incremental application of a standard hybrid resin-based composite (RBC) and sonicated application of a bulk-fill RBC in box-type and cylindrical cavity preparations. Experimental restorations were fabricated using molds of box-type or cylindrical preparations. For bulk-filled specimens, a single compule of bulk-fill composite was dispensed with a sonic handpiece. The conventional hybrid material was placed in 3 increments (2 mm, 2 mm, and 1 mm). Microfocus x-ray computed tomography was used to analyze voids for percentage and total volume porosity as well as number of actual pores. An analysis of variance indicated that RBC restorations that were applied to cylindrical cavities using a sonicated bulk-filled application method exhibited significantly less porosity (1.42%; P < 0.001) than incrementally placed cylindrical restorations (2.87%); sonicated bulk-filled, cube-shaped restorations (3.12%); and incrementally placed cube-shaped restorations (5.16%). When the groups were subcategorized into the specific characteristics of shape (cube vs cylinder) and application method (bulk vs incremental), the cylindrical group, which included both bulk-filled and incrementally placed specimens, demonstrated significantly less porosity (2.00%; P < 0.001) than other groups. Restorations that were incrementally placed into cube-shaped cavities produced the largest amount of porosity.