The new generation of conventional and bulk-fill composites do not reduce the shrinkage stress in endodontically-treated molars

Abstract

Purpose: To compare flowable and regular paste bulk-fill resin composites with old and new generation conventional composites that use incremental filling techniques for direct restoration of endodontically-treated teeth.

Methods: Four resin composites produced by the same company (3M-ESPE) were used: two conventional resin composites (old formulation, Z100, and new nanofilled formulation, Filtek Supreme XT); and two bulk-fill resin composites (flowable composite, Filtek Bulk-fill Flowable associated with Filtek Supreme, and regular paste, Filtek Bulk-fill Posterior). Elastic modulus (E), Vickers hardness (VH), post-gel shrinkage (Shr), diametral tensile strength (DTS) and compressive strength (CS) were determined (n= 10) and statistically analyzed using ANOVA and Tukey's test (α=0.05). Shrinkage stresses were analyzed using non-linear finite element analysis.

Results: Filtek Bulk-fill flowable and Filtek Supreme XT had higher CS than Z100 and Filtek Bulk-fill Posterior. Z100 and Filtek Supreme XT had higher DTS than Filtek Bulk-fill Posterior. Filtek Bulk-fill flowable had the lowest values and Z100 the highest E and Shr. Z100 resulted in higher stresses in the enamel and in root dentin close to the pulp chamber than the other filling techniques. Filtek Bulk-fill Flowable resulted in lower stress than other resin composites.

Clinical significance: Using bulk-fill composites, especially flowable resin composite, created lower stresses in restored endodontically-treated teeth. Clinicians, when deciding for direct restoration of endodontically-treated teeth, may choose the bulk-fill composite to decrease undesirable effects of direct restoration while simplifying filling procedure.