Leticia Cristina Cidreira Boaro1, Diana Pereira Lopes2, Andréia Santos Caetano de Souza3, Ellea Lie Nakano4, Mirko Dennys Ayala Perez5, Carmem Silvia Pfeifer6, Flávia Gonçalves7. 1. Universidade Santo Amaro, Faculdade de Odontologia. Av. Prof. Eneas de Siqueira Neto, 340. 04829-900, São Paulo, SP, Brazil. Electronic address: leticiacidreiraboaro@gmail.com. 2. University Ibirapuera, Departamento de Odontologia. Av. Interlagos, 1329. Chácara Flora. 04661-100, São Paulo, SP, Brazil. Electronic address: drdianapereiralopes@gmail.com. 3. University Ibirapuera, Departamento de Odontologia. Av. Interlagos, 1329. Chácara Flora. 04661-100, São Paulo, SP, Brazil. Electronic address: andreia.caetanodesouza@gmail.com. 4. University Ibirapuera, Departamento de Odontologia. Av. Interlagos, 1329. Chácara Flora. 04661-100, São Paulo, SP, Brazil. Electronic address: ellealie@gmail.com. 5. Universidade Santo Amaro, Faculdade de Odontologia. Av. Prof. Eneas de Siqueira Neto, 340. 04829-900, São Paulo, SP, Brazil. Electronic address: ayalamirko@gmail.com. 6. Oregon Health & Science University. School of Dentistry. Department of Restorative Dentistry, Portland, OR, USA. Electronic address: pfeifercs@gmail.com. 7. University Ibirapuera, Departamento de Odontologia. Av. Interlagos, 1329. Chácara Flora. 04661-100, São Paulo, SP, Brazil. Electronic address: flavia.goncalves@ibirapuera.edu.br.
Abstract
OBJECTIVES: The objective of this study was to perform a meta-analysis of clinical and laboratory studies to compare the performance of bulk-fill and conventional composite resins in terms of polymerization shrinkage, polymerization stress, cusp deflection, marginal quality, degree of conversion, microhardness, flexural strength, fracture strength and clinical performance. DATA: One hundred three articles were included in this study, and the Peto method was used to compare the bulk-fill and conventional composites using the RevMan software. SOURCES: Searches were performed in the PubMed and Scopus databases. STUDY SELECTION: Laboratory studies and randomized clinical trials comparing one of the previous detailed outcomes between bulk-fill and control composites were included. CONCLUSIONS: The bulk-fill composite resins showed less shrinkage, polymerization stress, cusp deflection and microhardness than conventional composites, while both materials presented a similar marginal quality, flexural strength and fracture strength. Also, bulk-fill materials with regular viscosity showed similar shrinkage. The conversion of bulk-fill materials with flowable consistency were similar to conventional composite resins with a thickness of up to 2mm and greater than conventional composites with a thickness greater than 2mm. Despite these in vitro differences, the clinical performance of bulk-fill and conventional composite resins was similar in randomized clinical trials, with one to ten years of follow up. In conclusion, the bulk-fill materials show better or similar performance to the conventional materials in clinical trials and laboratory studies in terms of volumetric shrinkage, polymerization stress, cusps deflection and marginal quality, with the only exception being the lower level of microhardness observed for bulk-fill composites with thickness up to 2mm.
OBJECTIVES: The objective of this study was to perform a meta-analysis of clinical and laboratory studies to compare the performance of bulk-fill and conventional composite resins in terms of polymerization shrinkage, polymerization stress, cusp deflection, marginal quality, degree of conversion, microhardness, flexural strength, fracture strength and clinical performance. DATA: One hundred three articles were included in this study, and the Peto method was used to compare the bulk-fill and conventional composites using the RevMan software. SOURCES: Searches were performed in the PubMed and Scopus databases. STUDY SELECTION: Laboratory studies and randomized clinical trials comparing one of the previous detailed outcomes between bulk-fill and control composites were included. CONCLUSIONS: The bulk-fill composite resins showed less shrinkage, polymerization stress, cusp deflection and microhardness than conventional composites, while both materials presented a similar marginal quality, flexural strength and fracture strength. Also, bulk-fill materials with regular viscosity showed similar shrinkage. The conversion of bulk-fill materials with flowable consistency were similar to conventional composite resins with a thickness of up to 2mm and greater than conventional composites with a thickness greater than 2mm. Despite these in vitro differences, the clinical performance of bulk-fill and conventional composite resins was similar in randomized clinical trials, with one to ten years of follow up. In conclusion, the bulk-fill materials show better or similar performance to the conventional materials in clinical trials and laboratory studies in terms of volumetric shrinkage, polymerization stress, cusps deflection and marginal quality, with the only exception being the lower level of microhardness observed for bulk-fill composites with thickness up to 2mm.