Friday, March 01, 2013

Bulk-filling of high C-factor posterior cavities: Effect on adhesion to cavity-bottom dentin

I now bulk fill most of my posterior composites.  You must used good technique and the correct materials. Here is yet another study that says bulk filling works. MJ

Dental Materials
Volume 29, Issue 3 , Pages 269-277, March 2013

 

Abstract 

Objectives

To evaluate the effect of bulk-filling high C-factor posterior cavities on adhesion to cavity-bottom dentin.

Methods

A universal flowable composite (G-ænial Universal Flo, GC), a bulk-fill flowable base composite (SDR Posterior Bulk Fill Flowable Base, Dentsply) and a conventional paste-like composite (Z100, 3M ESPE) were bonded (G-ænial Bond, GC) into standardized cavities with different cavity configurations (C-factors), namely C=3.86 (Class-I cavity of 2.5mm deep, bulk-filled), C=5.57 (Class-I cavity of 4mm deep, bulk-filled), C=1.95 (Class-I cavity of 2.5mm deep, filled in three equal layers) and C=0.26 (flat surface). After one-week water storage, the restorations were sectioned in 4 rectangular micro-specimens and subjected to a micro-tensile bond strength (μTBS) test.

Results

Highly significant differences were found between pairs of means of the experimental groups (Kruskal–Wallis, p<0.0001). Using the bulk-fill flowable base composite SDR (Dentsply), no significant differences in μTBS were measured among all cavity configurations (p>0.05). Using the universal flowable composite G-ænial Universal Flo (GC) and the conventional paste-like composite Z100 (3M ESPE), the μTBS to cavity-bottom dentin was not significantly different from that of SDR (Dentsply) when the cavities were layer-filled or the flat surface was build up in layers; it was however significantly lower when the Class-I cavities were filled in bulk, irrespective of cavity depth.

Significance

The filling technique and composite type may have a great impact on the adhesion of the composite, in particular in high C-factor cavities. While the bulk-fill flowable base composite provided satisfactory bond strengths regardless of filling technique and cavity depth, adhesion failed when conventional composites were used in bulk.

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