Non-Cochrane · intervention · PM41598355
Clinical Performance and Survival of Bulk-Fill Resin Composite Posterior Restorations in Primary Teeth: A Systematic Review and Meta-Analysis.
Miranda Samille Biasi, Lins Rodrigo Barros Esteves, Queiroz Matheus de Farias, et al. · Journal of clinical medicine · 2026 · PubMed · doi:10.3390/jcm15020415
Findings
Population Children with posterior restorations in primary molars
9 findings
| Bulk-fill resin composite (direct restoration) | Conventional incremental resin composite | Marginal integrity (USPHS/FDI Charlie or score 4-5 failures) 12 months · Clinical setting; Class II cavities; follow-up 6 to 12 months · Class II cavities | RD -0.02 [-0.07, 0.03] Moderate Downgraded: imprecision 2 studies · 242 participants |
| Bulk-fill resin composite (direct restoration) | Conventional incremental resin composite | Color match (USPHS/FDI Charlie or score 4-5 failures) 12 months · Clinical setting; Class II cavities; follow-up 6 to 12 months · Class II cavities | RD 0.00 [-0.02, 0.02] Moderate Downgraded: imprecision 2 studies · 242 participants |
| Bulk-fill resin composite (direct restoration) | Conventional incremental resin composite | Color match (USPHS/FDI Charlie or score 4-5 failures) 6 months · Clinical setting; Class II cavities; follow-up 6 to 12 months · Class II cavities | RD 0.00 [-0.02, 0.02] Moderate Downgraded: imprecision 2 studies · 242 participants |
| Bulk-fill resin composite (direct restoration) | Conventional incremental resin composite | Marginal discoloration (USPHS/FDI Charlie or score 4-5 failures) 6 months · Clinical setting; Class II cavities; follow-up 6 to 12 months · Class II cavities | RD 0.00 [-0.02, 0.02] Moderate Downgraded: imprecision 2 studies · 242 participants |
| Bulk-fill resin composite (direct restoration) | Conventional incremental resin composite | Marginal integrity (USPHS/FDI Charlie or score 4-5 failures) 6 and 12 months combined · Clinical setting; Class II cavities; follow-up 6 to 12 months · Class II cavities; all timepoints | RD 0.00 [-0.02, 0.02] Moderate Downgraded: imprecision 2 studies · 484 participants |
| Bulk-fill resin composite (direct restoration) | Conventional incremental resin composite | Color match (USPHS/FDI Charlie or score 4-5 failures) 6 and 12 months combined · Clinical setting; Class II cavities; follow-up 6 to 12 months · Class II cavities; all timepoints | RD 0.00 [-0.02, 0.02] Moderate Downgraded: imprecision 2 studies · 484 participants |
| Bulk-fill resin composite (direct restoration) | Conventional incremental resin composite | Marginal integrity (USPHS/FDI Charlie or score 4-5 failures) 6 months · Clinical setting; Class II cavities; follow-up 6 to 12 months · Class II cavities | RD 0.00 [-0.02, 0.02] Moderate Downgraded: imprecision 2 studies · 242 participants |
| Bulk-fill resin composite (direct restoration) | Conventional incremental resin composite | Marginal discoloration (USPHS/FDI Charlie or score 4-5 failures) 12 months · Clinical setting; Class II cavities; follow-up 6 to 12 months · Class II cavities | RD 0.00 [-0.02, 0.02] Moderate Downgraded: imprecision 2 studies · 242 participants |
| Bulk-fill resin composite (direct restoration) | Conventional incremental resin composite | Marginal discoloration (USPHS/FDI Charlie or score 4-5 failures) 6 and 12 months combined · Clinical setting; Class II cavities; follow-up 6 to 12 months · Class II cavities; all timepoints | RD 0.00 [-0.02, 0.02] Moderate Downgraded: imprecision 2 studies · 484 participants |
Included primary studies 6
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Akman and Tosun 2020 Clinical evaluation of bulk-fill resins and glass ionomer restorative materials: A 1-year follow-up randomized clinical trial in children. PMID:32246655 | 2020 | 3 other reviews | Color match (USPHS/FDI Charlie or score 4-5 failures); Marginal discoloration (USPHS/FDI Charlie or score 4-5 failures); Marginal integrity (USPHS/FDI Charlie or score 4-5 failures) | not extracted yet |
| Ehlers et al. 2019 One-year Clinical Performance of Flowable Bulk-fill Composite vs Conventional Compomer Restorations in Primary Molars. PMID:31093618 | 2019 | this review only | not stated | not extracted yet |
| Gindri et al. 2022 One-year clinical evaluation of class II bulk-fill restorations in primary molars: a randomized clinical trial. PMID:36477958 | 2022 | this review only | Color match (USPHS/FDI Charlie or score 4-5 failures); Marginal discoloration (USPHS/FDI Charlie or score 4-5 failures); Marginal integrity (USPHS/FDI Charlie or score 4-5 failures) | not extracted yet |
| Massa et al. 2022 Use of bulk fill resin composite and universal adhesive for restoring primary teeth after selective carious tissue removal to soft dentin:… PMID:35506965 | 2022 | this review only | not stated | not extracted yet |
| Oter, Deniz and Cehreli 2019 Preliminary data on clinical performance of bulk-fill restorations in primary molars. PMID:30417848 | 2018 | this review only | not stated | not extracted yet |
| Sarapultseva and Sarapultseva 2019 Flowable Bulk-Fill Materials Compared to Nano Ceramic Composites for Class I Cavities Restorations in Primary Molars: A Two-Year… PMID:31557829 | 2019 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with posterior restorations in primary (deciduous) teeth | Children aged 3 to 10 years with Class I or II primary molar cavities (n=1220 restorations; 27 to 80 children per trial) |
| Intervention | Direct restoration with bulk-fill resin composite | Bulk-fill RBC (Filtek Bulk Fill, Venus Bulk Fill, SonicFill, X-tra fil, SDR) (n=631 restorations) |
| Comparison | Conventional resin composite (incremental technique) or glass ionomer cement | Conventional RBC (n=451) or glass ionomer cement (n=138) |
| Outcomes | Survival (primary); color match, marginal discoloration, marginal integrity, postoperative sensitivity, secondary caries, retention, anatomical form (USPHS or FDI criteria) | Color match, marginal discoloration, marginal integrity pooled; secondary caries, fracture, retention, anatomical form synthesized descriptively |
| Study designs | Randomized clinical trials | RCTs (n=6) |
| Timing | Not specified | 6 to 24 months follow-up |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | Yes | no |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |