Material Matches Conventional Composites in Bulk-Fill Applications



The Biomedical Research Group of Umeå University in Sweden has demonstrated that Dentsply Sirona’s SureFil SDR flow+ material can be used in bulk-fill applications with results comparable to conventional composites using a layered technique.

The researchers used SureFil SDR flow+ in 100 Class I and Class II bulk-fill restorations with applications up to 4 mm deep. The control restorations were performed using an industry-standard composite in multiple layers, using an oblique layering technique when possible.

Layers were light-cured for at least 20 seconds. All restorations were bonded with the same self-etching adhesive. Occlusal surfaces were finished with the same universal composite material.

The bulk-fill and layered restorations were performed on pairs of cavities with similar characteristics on the same patients for the most direct comparison of durability and wear throughout time. Also, a baseline evaluation was performed.

Restorations were re-evaluated at yearly intervals for 5 years to assess anatomic form, marginal adaptation, marginal discoloration, surface roughness, color match, and secondary caries.

Both restorative techniques showed good surface, marginal, and color stability, the researchers reported, with substantially equivalent durability. They also attributed the few failures that occurred in the Class II restorations primarily to tooth fracture and secondary caries.

Although the difference was not statistically significant, the annual failure rate for the bulk-fill technique was lower than the failure rate for layered-fill restorations: 1.4% versus 2.1%, respectively.      

The researchers concluded that the traditional layering technique and the bulk-fill technique both provide the same clinical efficacy in a 5-year period. Also, the study did not report any cases of postoperative sensitivity among any of the participants.

According to Dentsply Sirona, dentists can choose SureFil SDR flow+ material for all the advantages of the bulk-fill technique with no compromise in patient comfort, long-term durability, or aesthetics.

The company also says that its highly flowable consistency provides excellent cavity adaptation, even in the deepest corners of the proximal box. Requiring no further manipulation, its self-leveling property provides an optimum base for the final occlusal layer and simplifies placement even on maxillary posterior teeth, according to Dentsply Sirona.

Furthermore, the company notes, the unique SDR chemistry provides up to 60% less polymerization stress compared to other flowable and universal composites, including other bulk-fill materials, allowing layers up to 4 mm thick even in high C-factor cavities.

SureFil SDR flow+ offers A1, A2, and A3 shades in addition to the original universal shade, along with greater wear resistance and radiopacity as well as approval for use in a wider range of cases beyond Class I and II, Dentsply Sirona states, and has been placed in 44 million restorations by more than 84,000 dentists worldwide.

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