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Review
. 2020 Aug 10;12(8):1786.
doi: 10.3390/polym12081786.

Clinical Effectiveness of Bulk-Fill and Conventional Resin Composite Restorations: Systematic Review and Meta-Analysis

Heber Isac Arbildo-Vega  1   2 , Barbara Lapinska  3 , Saurav Panda  4   5 , César Lamas-Lara  6 , Abdul Samad Khan  7 , Monika Lukomska-Szymanska  3
Affiliations
Review

Clinical Effectiveness of Bulk-Fill and Conventional Resin Composite Restorations: Systematic Review and Meta-Analysis

Heber Isac Arbildo-Vega et al. Polymers (Basel). .

Abstract

The objective of this systematic review and meta-analysis was to determine the clinical effectiveness of bulk-fill and conventional resin in composite restorations. A bibliographic search was carried out until May 2020, in the biomedical databases Pubmed/MEDLINE, EMBASE, Scopus, CENTRAL and Web of Science. The study selection criteria were: randomized clinical trials, in English, with no time limit, with a follow-up greater than or equal to 6 months and that reported the clinical effects (absence of fractures, absence of discoloration or marginal staining, adequate adaptation marginal, absence of post-operative sensitivity, absence of secondary caries, adequate color stability and translucency, proper surface texture, proper anatomical form, adequate tooth integrity without wear, adequate restoration integrity, proper occlusion, absence of inflammation and adequate point of contact) of restorations made with conventional and bulk resins. The risk of bias of the study was analyzed using the Cochrane Manual of Systematic Reviews of Interventions. Sixteen articles were eligible and included in the study. The results indicated that there is no difference between restorations with conventional and bulk resins for the type of restoration, type of tooth restored and restoration technique used. However, further properly designed clinical studies are required in order to reach a better conclusion.

Keywords: bulk-fill resin; dental restoration; meta-analysis; resin composite; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Absence of Fractures: Conventional Resin versus Bulk Resin Covered with Conventional Resin According to Type of Restoration.
Figure A2
Figure A2
Absence of Fractures: Conventional Resin versus Bulk Resin According to Type of Restoration.
Figure A3
Figure A3
Absence of Fractures: Conventional Resin versus Bulk Resin According to Type of Teething.
Figure A4
Figure A4
Absence of Fractures: Conventional Resin versus Bulk Resin According to the Technique Used.
Figure A5
Figure A5
Absence of Fractures: Bulk Resin (with Sonic Activation) versus Bulk Resin (Two-Step Technique).
Figure A6
Figure A6
Absence of Discoloration or Marginal Staining: Conventional Resin versus Bulk Resin Covered with Conventional Resin According to Type of Restoration.
Figure A7
Figure A7
Absence of Discoloration or Marginal Staining: Conventional Resin versus Bulk Resin According to Type of Restoration.
Figure A8
Figure A8
Absence of Discoloration or Marginal Staining: Conventional Resin versus Bulk Resin According to Type of Teething.
Figure A9
Figure A9
Absence of Discoloration or Marginal Staining: Conventional Resin versus Bulk Resin According to the Technique Used.
Figure A10
Figure A10
Absence of Discoloration or Marginal Staining: Bulk Resin (with Sonic Activation) versus Bulk Resin (Two-Step Technique).
Figure A11
Figure A11
Adequate Marginal Adaptation: Conventional Resin versus Bulk Resin Covered with Conventional Resin According to Type of Restoration.
Figure A12
Figure A12
Adequate Marginal Adaptation: Conventional Resin versus Bulk Resin According to Type of Restoration.
Figure A13
Figure A13
Adequate Marginal Adaptation: Conventional Resin versus Bulk Resin According to Type of Teething.
Figure A14
Figure A14
Adequate Marginal Adaptation: Conventional Resin versus Bulk Resin According to the Technique Used.
Figure A15
Figure A15
Adequate Marginal Adaptation: Bulk Resin (with Sonic Activation) versus Bulk Resin (Two-Step Technique).
Figure A16
Figure A16
Absence of Post-Operative Sensitivity: Conventional Resin versus Bulk Resin Covered with Conventional Resin According to Type of Restoration.
Figure A17
Figure A17
Absence of Post-Operative Sensitivity: Conventional Resin versus Bulk Resin According to Type of Restoration.
Figure A18
Figure A18
Absence of Post-Operative Sensitivity: Conventional Resin versus Bulk Resin According to Type of Teething.
Figure A19
Figure A19
Absence of Post-Operative Sensitivity: Conventional Resin versus Bulk Resin According to the Technique Used.
Figure A20
Figure A20
Absence of Post-Operative Sensitivity: Bulk Resin (with Sonic Activation) versus Bulk Resin (Two-Step Technique).
Figure A21
Figure A21
Absence of Secondary Caries: Conventional Resin versus Bulk Resin Covered with Conventional Resin According to Type of Restoration.
Figure A22
Figure A22
Absence of Secondary Caries: Conventional Resin versus Bulk Resin According to Type of Restoration.
Figure A23
Figure A23
Absence of Secondary Caries: Conventional Resin versus Bulk Resin According to Type of Teething.
Figure A24
Figure A24
Absence of Secondary Caries: Conventional Resin versus Bulk Resin According to the Technique Used.
Figure A25
Figure A25
Absence of Secondary Caries: Bulk Resin (with Sonic Activation) versus Bulk Resin (Two-Step Technique).
Figure A26
Figure A26
Adequate Color Stability and Translucency: Conventional Resin versus Bulk Resin Covered with Conventional Resin According to Type of Restoration.
Figure A27
Figure A27
Adequate Color Stability and Translucency: Conventional Resin versus Bulk Resin According to Type of Restoration.
Figure A28
Figure A28
Adequate Color Stability and Translucency: Conventional Resin versus Bulk Resin According to Type of Teething.
Figure A29
Figure A29
Adequate Color Stability and Translucency: Conventional Resin versus Bulk Resin According to the Technique Used.
Figure A30
Figure A30
Adequate Color Stability and Translucency: Bulk Resin (with Sonic Activation) versus Bulk Resin (Two-Step Technique).
Figure A31
Figure A31
Proper Surface Texture: Conventional Resin versus Bulk Resin Covered with Conventional Resin According to Type of Restoration.
Figure A32
Figure A32
Proper Surface Texture: Conventional Resin versus Bulk Resin According to Type of Restoration.
Figure A33
Figure A33
Proper Surface Texture: Conventional Resin versus Bulk Resin According to Type of Teething.
Figure A34
Figure A34
Proper Surface Texture: Conventional Resin versus Bulk Resin According to the Technique Used.
Figure A35
Figure A35
Proper Anatomical Form: Conventional Resin versus Bulk Resin Covered with Conventional Resin According to Type of Restoration.
Figure A36
Figure A36
Proper Anatomical Form: Conventional Resin versus Bulk Resin According to Type of Restoration.
Figure A37
Figure A37
Proper Anatomical Form: Conventional Resin versus Bulk Resin According to Type of Teething.
Figure A38
Figure A38
Proper Anatomical Form: Conventional Resin versus Bulk Resin According to the Technique Used.
Figure A39
Figure A39
Proper Anatomical Form: Bulk Resin (with Sonic Activation) versus Bulk Resin (Two-Step Technique).
Figure A40
Figure A40
Adequate Tooth Integrity: Conventional Resin versus Bulk Resin Covered with Conventional Resin.
Figure A41
Figure A41
Adequate Tooth Integrity: Conventional Resin versus Bulk Resin.
Figure A42
Figure A42
Adequate Tooth Integrity: Conventional Resin versus Bulk Resin According to the Technique Used.
Figure A43
Figure A43
Adequate Restoration Integrity: Conventional Resin versus Bulk Resin Covered with Conventional Resin.
Figure A44
Figure A44
Adequate Restoration Integrity: Conventional Resin versus Bulk Resin.
Figure A45
Figure A45
Adequate Restoration Integrity: Conventional Resin versus Bulk Resin According to the Technique Used.
Figure A46
Figure A46
Proper Occlusion: Conventional Resin versus Bulk Resin.
Figure 1
Figure 1
PRISMA flow diagram of the literature search and selection process. Note: PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses [12].
Figure 2
Figure 2
Risk of bias.
See this image and copyright information in PMC

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