Restorative & Aesthetic Dentistry

Choosing Between Bulk Fill and Incremental Fill Composites: Long-Term Reliability!

Class II restorations are a common procedure in dental practice. The choice of material and technique significantly impacts the restoration's durability,...

Dr. Zainab Rangwala

Dr. Zainab Rangwala

Chief Dentist · GDCHJ

3 min read51,930 views
  • professional education
  • restorative materials
  • incremental fill
  • class ii restorations
  • dentistry
  • bulk fill
  • clinical trial
  • composite restorations
  • Restorative & Aesthetic Dentistry
  • Clinical & Academic Article
Class II restorations are a common procedure in dental practice. The choice of material and technique significantly impacts the restoration's durability, aesthetics, and overall success rate. This study evaluated these aspects by comparing two distinct approaches: using a flowable bulk-fill base covered with conventional viscosity material (Bulk-fill technique) versus employing only the conventional material in incremental layers (Layering technique) The study was conducted as a split-mouth randomized clinical trial involving thirty patients. Each patient received two Class II restorations, resulting in a total of 60 restorations. The procedures were standardized as follows:
  1. Adhesive Application: A universal self-etching adhesive system was applied according to the manufacturer's instructions.
  2. Matrix System: A sectional matrix, wooden wedge, and separation ring were used to ensure proper contour and contact.
  3. Restoration Techniques:
  • Bulk-Fill Technique: 4 mm of flowable bulk-fill material was placed as a base layer, followed by 2 mm of conventional viscosity restorative material.
  • Layering Technique: Conventional viscosity material was applied in increments no thicker than 2 mm until the cavity was filled.
  1. Finishing Touches: All restorations underwent occlusal adjustment and polishing using the same system.
Evaluations based on FDI criteria were performed at intervals of 7 days, 12 months, and 24 months post-restoration.

Results

Out of the initial thirty participants, twenty-four attended the final recall at 24 months, allowing for an evaluation of forty-eight restorations. The findings were summarized as follows:
  • Aesthetic Properties: Both groups maintained acceptable aesthetic scores throughout the evaluation period.
  • Biological Properties: No adverse biological reactions were observed in either group.
  • Functional Properties: A small percentage (6.66%) exhibited unacceptable functional scores; however, this was consistent across both groups.

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References

  1. [1]Young DA, Nový BB, Zeller GG, et al.. The American Dental Association Caries Classification System for Clinical Practice Journal of the American Dental Association. 2015. DOI: 10.1016/j.adaj.2014.11.018. Available at: source
  2. [2]Miao C, Yang X, Wong MCM, et al.. Rubber dam isolation for restorative treatment in dental patients Cochrane Database of Systematic Reviews. 2021. DOI: 10.1002/14651858.CD009858.pub3. Available at: source

Written by

Dr. Zainab Rangwala

Dr. Zainab Rangwala

Chief Dentist · GDCHJ

With over 12 years of clinical experience, Dr. Zainab Rangwala brings a unique blend of clinical expertise and communication excellence to her role as the Media and PR Head at DentalReach. Passionate about bridging the gap between dentistry and digital communication, she plays a key role in shaping the platform’s voice and outreach.

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