State of the art of bulk-fill resin-based composites: a review

  • Camila Corral-Núñez Universidad de Chile
  • Patricio Vildósola-Grez Universidad de Chile
  • Cristian Bersezio-Miranda Universidad de Chile
  • Edson Alves-Dos Campos UNESP
  • Eduardo Fernández-Godoy Universidad de Chile
Keywords: Dental materials, Permanent dental restoration, Synthetic resins


Bulk-fill resin-based composites (RBCs) have recently been introduced on the market, and according to the manufacturers, they could be used to restore cavities in 4- or 5-mm thick increments. This would probably mean a major technique simplification compared to the incremental technique. However, the properties and modes of use of RBCs vary significantly between one and the other. In addition, due to their recent appearance on the market, there are not enough studies that validate the clinical performance of these materials. This article aims to conduct a state of the art review of the available literature on the Medline/Pubmed and ScIELO databases, published between 2000 and 2014, describing the composition, classification, and results of studies currently published.

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Author Biographies

Camila Corral-Núñez, Universidad de Chile
DMD, MClinDent. Ph.D (p) UNESP,Instructor, Department of Restorative Dentistry, School of Dentistry, Universidad de Chile, Chile
Patricio Vildósola-Grez, Universidad de Chile
DMD, Ph.D. (c). Assistant Professor, Department of Restorative Dentistry, School of Dentistry, Universidad de Chile, Chile
Cristian Bersezio-Miranda, Universidad de Chile
DMD, Ph.D. (c). Assistant Professor, Department of Restorative Dentistry, School of Dentistry, Universidad de Chile, Chile
Edson Alves-Dos Campos, UNESP
DMD, Ph.D. Professor LD, Restorative Dentistry Department, School of Dentistry Araraquara, UNESP, Brazil.
Eduardo Fernández-Godoy, Universidad de Chile
DMD, Ph.D. Associate Professor, Department of Restorative Dentistry, School of Dentistry, Universidad de Chile, Chile


Malhotra N, Mala K, Acharya S. Resin-based composite as a direct esthetic restorative material. Compend Contin Educ Dent 2011; 32(5): 14-23.

Malhotra N, Kundabala M, Shashirashmi A. Strategies to overcome polymerization shrinkage-materials and techniques. A review. Dent Update 2010; 37(2): 115-118.

Moore BK, Platt JA, Borges G, Chu TM, Katsilieri I. Depth of cure of dental resin composites: ISO 4049 depth and microhardness of types of materials and shades. Oper Dent 2008; 33(4): 408-412.

Braga RR, Ballester RY, Ferracane JL. Factors involved in the development of polymerization shrinkage stress in resin-composites: a systematic review. Dent Mater 2005; 21(10): 962-970.

Lindberg A, Peutzfeldt A, van Dijken JW. Effect of power density of curing unit, exposure duration, and light guide distance on composite depth of cure. Clin Oral Investig 2005; 9(2): 71-76.

Park J, Chang J, Ferracane J, Lee IB. How should composite be layered to reduce shrinkage stress: incremental or bulk filling? Dent Mater 2008; 24(11): 1501-1505

Leprince JG, Leveque P, Nysten B, Gallez B, Devaux J, Leloup G. New insight into the “depth of cure” of dimethacrylate-based dental composites. Dent Mater 2012; 28(5): 512-520.

Sakaguchi RL, Douglas WH, Peters MC. Curing light performance and polymerization of composite restorative materials. J Dent 1992; 20(3): 183-188.

Pilo R, Oelgiesser D, Cardash HS. A survey of output intensity and potential for depth of cure among light-curing units in clinical use. J Dent 1999; 27(3): 235-241.

Ilie N, Hickel R. Investigations on a methacrylate-based flowable composite based on the SDRTM technology. Dent Mater 2011; 27(4): 348-355.

Versluis A, Douglas WH, Cross M, Sakaguchi RL. Does an incremental filling technique reduce polymerization shrinkage stresses? J Dent Res 1996; 75(3): 871-878.

Loguercio AD, Reis A, Ballester RY. Polymerization shrinkage: effects of constraint and filling technique in composite restorations. Dent Mater 2004; 20(3): 236-243.

Rees JS, Jagger DC, Williams DR, Brown G, Duguid W. A reappraisal of the incremental packing technique for light cured composite resins. J Oral Rehabil 2004; 31(1): 81-84.

Dentsply. SureFil SDR flow: posterior bulk fill flowable base [internet]. Milford: DENTSPLY; 2011 [Consultado 2014 mar 10]. Disponible en:

M ESPE. Filtek Bulk Fill Flowable Restorative 3M ESPE, Instructions. [Internet]. [Consultado 2014 Mar 10]. Disponible en:

Voco. X-tra base: in accordance with DIN EN ISO 4049: instructions for use. Cuxhaven, Alemania: Voco; [Consultado 2014 mar 10]. Disponible en:

Heraeus. Venus Bulk Fill, Heraeus. [Internet]. [Consultado 2014 Mar 10]. Disponible en:

Ilie N, Bucuta S, Draenert M. Bulk-fill resin-based composites: an in vitro assessment of their mechanical performance. Oper Dent 2013; 38(6): 618-625.

Ivoclar Vivadent. Tetric Evoceram Bulkfill, Instructions for use. [Internet]. [Consultado 2014 Mar 11]. Disponible en:

VOCO. x-tra fil VOCO. [Internet]. [Consultado 2014 Mar 11]. Disponible en:

Kerr. Sonic Fill Composite Kerr. [Internet]. [Consultado 2014 Mar 11]. Disponible en:

Roggendorf MJ, Kramer N, Appelt A, Naumann M, Frankenberger R. Marginal quality of flowable 4-mm base vs. conventionally layered resin composite. J Dent 2011; 39(10): 643-647.

Burgess J, Cakir D. Comparative properties of low-shrinkage composite resins. Compend Contin Educ Dent 2010; 31(2): 10-15.

Peutzfeldt A. Resin composites in dentistry: the monomer systems. Eur J Oral Sci 1997; 105(2): 97-116.

M ESPE. Filtek Bulk Fill Flowable Restorative, Technical Product Profile. [Internet]. [Consultado 2014 Mar 27]. Disponible en:

Moszner N, Fischer UK, Ganster B, Liska R, Rheinberger V. Benzoyl germanium derivatives as novel visible light photoinitiators for dental materials. Dent Mater 2008; 24(7): 901-907.

Czasch P, Ilie N. In vitro comparison of mechanical properties and degree of cure of bulk fill composites. Clin Oral Investig 2013; 17(1): 227-235.

Ilie N, Hickel R. Investigations on mechanical behaviour of dental composites. Clin Oral Investig 2009; 13(4): 427-438.

Leprince JG, Palin WM, Vanacker J, Sabbagh J, Devaux J, Leloup G. Physico-mechanical characteristics of commercially available bulk-fill composites. J Dent 2014; 42(8): 993-1000.

Ferracane JL, Mitchem JC, Condon JR, Todd R. Wear and marginal breakdown of composites with various degrees of cure. J Dent Res 1997; 76(8): 1508-1516.

Ilie N, Hickel R. Quality of curing in relation to hardness, degree of cure and polymerization depth measured on a nano-hybrid composite. Am J Dent 2007; 20(4): 263-268.

Durner J, Obermaier J, Draenert M, Ilie N. Correlation of the degree of conversion with the amount of elutable substances in nano-hybrid dental composites. Dent Mater 2012; 28(11): 1146-1153.

Aranha AM, Giro EM, Hebling J, Lessa FC, Costa CA. Effects of light-curing time on the cytotoxicity of a restorative composite resin on odontoblast-like cells. J Appl Oral Sci 2010; 18(5): 461-466.

Kovarik RE, Ergle JW. Fracture toughness of posterior composite resins fabricated by incremental layering. J Prosthet Dent 1993; 69(6): 557-560.

St-Georges AJ, Swift EJ Jr., Thompson JY, Heymann HO. Curing light intensity effects on wear resistance of two resin composites. Oper Dent 2002; 27(4): 410-417.

Geurtsen W. Biocompatibility of resin-modified filling materials. Crit Rev Oral Biol Med 2000; 11(3): 333-355.

International Organization for Standardization. ISO 4049:2009 Dentistry-Polymer-based restorative materials. Ginebra: ISO; 2009.

Tiba A, Zeller G, Estrich C, Hong A. A laboratory evaluation of bulk-fill versus traditional multi-increment-fill resin-based-composites. J Am Dent Assoc 2013; 8(3): 13-26.

Garcia D, Yaman P, Dennison J, Neiva G. Polymerization shrinkage and depth of cure of bulk fill flowable composite resins. Oper Dent 2014; 39(4): 441-448.

DeWald JP, Ferracane JL. A comparison of four modes of evaluating depth of cure of light-activated composites. J Dent Res 1987; 66(3): 727-730.

Ferracane JL, Aday P, Matsumoto H, Marker VA. Relationship between shade and depth of cure for light-activated dental composite resins. Dent Mater 1986; 2(2): 80-84.

Flury S, Hayoz S, Peutzfeldt A, Hüsler J, Lussi A. Depth of cure of resin composites: is the ISO 4049 method suitable for bulk fill materials? Dent Mater 2012; 28(5): 521-528.

Alrahlah A, Silikas N, Watts DC. Post-cure depth of cure of bulk fill dental resin-composites. Dent Mater 2014; 30(2): 149-154.

Ilie N, Keßler A, Durner J. Influence of various irradiation processes on the mechanical properties and polymerisation kinetics of bulk-fill resin based composites. J Dent 2013; 41(8): 695-702.

Goracci C, Cadenaro M, Fontanive L, Giangrosso G, Juloski J, Vichi A et al. Polymerization efficiency and flexural strength of low-stress restorative composites. Dent Mater 2014; 30(6): 688-694.

Martin FE. A survey of the efficiency of visible light curing units. J Dent 1998; 26(3): 239-243.

Krämer N, Lohbauer U, García-Godoy F, Frankenberger R. Light curing of resin-based composites in the LED era. Am J Dent 2008; 21(3): 135-142.

Ferracane JL. Developing a more complete understanding of stresses produced in dental composites during polymerization. Dent Mater 2005; 21(1): 36-42.

Ferracane JL. Buonocore Lecture. Placing dental composites-a stressful experience. Oper Dent 2008; 33(3): 247-257.

Anusavice K. Phillips’ science of dental materials. 11 ed. St. Louis: Saunders; 2003.

Moorthy A, Hogg CH, Dowling AH, Grufferty BF, Benetti AR, Fleming GJ. Cuspal deflection and microleakage in premolar teeth restored with bulk-fill flowable resin-based composite base materials. J Dent 2012; 40(6): 500-505.

Ilie N, Hickel R. Investigations on a methacrylate-based flowable composite based on the SDR technology. Dent Mater 2011;27(4):348-355.

El-Damanhoury H, Platt J. Polymerization shrinkage stress kinetics and related properties of Bulk-Fill resin composites. Oper Dent 2014; 39(4): 374-382.

Campos EA, Ardu S, Lefever D, Jassé FF, Bortolotto T, Krejci I. Marginal adaptation of class II cavities restored with bulk-fill composites. J Dent 2014; 42(5): 575-581.

Furness A, Tadros MY, Looney SW, Rueggeberg FA. Effect of bulk/incremental fill on internal gap formation of bulk-fill composites. J Dent 2014; 42(4): 439-449.

Arslan S, Demirbuga S, Ustun Y, Dincer AN, Canakci BC, Zorba YO. The effect of a new-generation flowable composite resin on microleakage in Class V composite restorations as an intermediate layer. J Conserv Dent 2013; 16(3): 189-193.

El-Safty S, Silikas N, Watts DC. Creep deformation of restorative resin-composites intended for bulk-fill placement. Dent Mater 2012; 28(8): 928-935.

Al-Ahdal K, Silikas N, Watts DC. Rheological properties of resin composites according to variations in composition and temperature. Dent Mater 2014; 30(5): 517-524.

Petrovic LM, Zorica DM, Stojanac IL, Krstonosic VS, Hadnadjev MS, Atanackovic TM. A model of the viscoelastic behavior of flowable resin composites prior to setting. Dent Mater 2013; 29(9): 929-934

Sadowsky SJ. An overview of treatment considerations for esthetic restorations: a review of the literature. J Prosthet Dent 2006; 96(6): 433-442.

Abbas G, Fleming GJ, Harrington E, Shortall AC, Burke FJ. Cuspal movement and microleakage in premolar teeth restored with a packable composite cured in bulk or in increments. J Dent 2003; 31(6): 437-444.

How to Cite
Corral-Núñez C., Vildósola-Grez P., Bersezio-Miranda C., Alves-Dos Campos E., & Fernández-Godoy E. (2015). State of the art of bulk-fill resin-based composites: a review. Revista Facultad De Odontología Universidad De Antioquia, 27(1), 177-196.