Clinical Insight Into Predictable Bulk Filling

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KEY TAKEAWAYS:

• Successful posterior composite restorations require materials ideally suited to address specific needs.
• New bulk-fill flowable composites have been developed for the effective use of 4-mm increments
• This new chemistry can mitigate the harmful effects of volumetric and polymerization shrinkage stress, resulting in greater marginal integrity and long-term success

Shrinkage stress remains a fundamental challenge for flowable composites. It can compromise the success of the restoration and contribute to a poor marginal seal, microleakage, microfracture, postoperative sensitivity, and recurrent caries.

In the past, composite resins often were not placed in increments larger than 2 mm because of shrinkage stress, and restoration of larger cavity forms was very time consuming. The average depth of a Class II cavity form is approximately 6 mm. No currently marketed bulk-fill material should be used in one increment if depth of the preparation is over 5 mm, therefore at least two increments are often necessary.

New bulk-fill flowable composites have been developed for the effective use of 4-mm increments, while decreasing shrinkage stresses generated during polymerization. When at least two increments are needed, a material that provides an excellent marginal seal against microleakage and protects against voids at the most vulnerable gingival interface is clearly the better option. Learn more about this unique chemistry.