Compósitos odontológicos do tipo Bulk fill: estado da arte e da técnica

Abstract

The bulk fill dental composites were developed as an alternative to simplify the restorative technique. Commercially they are available as direct restorative materials or as temporary materials, being indicated for definitive restoration of posterior teeth or for temporary sealing of cavities, respectively. The simplification of the restorative technique was only possible from the materials improvement. Therefore, this study aimed initially to review systematically in vitro studies with the purpose of evaluating chemical composition strategies available to reduce/control contraction stress development in dental resin-based restorative materials. The literature search was conducted in seven databases: PubMed, Web of Science, Scopus, SciELO, LILACS, Ibecs and BBO. A total of 62 studies were included in the qualitative analysis, and the meta-analysis was performed with 58 studies. The modification of the resin matrix contributes more to minimize stress development than filler phase and resin-filler interface. The stress decreasing technology used for low-shrinkage formulations and bulk-fill materials shows promising application for reducing/controlling stress development. In addition, a systematic review of in vitro and clinical studies was carried out to evaluate the performance of bulk fill composites compared to conventional composite resins. A total of 45 in vitro studies and 5 clinical trials were included in the analysis. In general, the in vitro and clinical studies suggest that bulk fill materials seem to perform similarly or better than conventional composite. Finally, it was developed a bulk fill dental composite with high polymerization depth, antimicrobial properties, and excellent marginal sealing for use as a temporary restorative material. In addition, it has the advantage of being easily applied and removed in the dental cavity. The use of bulk fill dental composites presented a potential application for posterior restoration purposes with the advantage of simplifying the operative technique and reducing the clinical time for restoration building up.