Desempenho clínico de restaurações de resina composta Bulk-Fill

Abstract

This study aimed to present a clinical case of the clinical performance of bulk-fill restorations. To that end, a patient was screened by means of the presence of three possible large posterior tooth cavities, in order to allow the fabrication of three restorations varying the operatory technique and resin composite restorative. The patient showed three provisional restorations made of glass ionomer at teeth 16, 26 and 36, which needed restoration with definitive materials. The teeth were photographed and sorted according to the restorative technique used: Tooth 16 – ‘combined bulk-fill’ technique, using a first increment of low viscosity bulk-fill resin (Opus Bulk Fill Flow; FGM), color A1, followed by an increment of traditional resin for enamel restoration (Opallis; FGM), also color A1; Tooth 26 – ‘control’ technique, using only traditional resin for dentin and enamel restoration (Opallis), color A1, with each increment being thinner than 1.5 mm of thickness; and Tooth 36 – ‘bulk-fill’ technique, using a single increment of nearly 5 mm-thick of a regular viscosity bulk-fill resin (Opus Bulk Fill), color A1. Each tooth was properly prepared and treated with two-step, total-etch adhesive system, and upon absolute isolation using rubber dam, each restorative technique was applied to the respective teeth. Light-activation of each increment was performed using a light emitting diode, using the suggested time as for the manufacturer’s directions of use. Occlusal adjustment was always performed by the end of the restorative procedure. Finishing and polishing were performed after one week, with byte-wing x-ray of each restoration. After 6 months, all restorations were x-rayed and photographed again, and evaluated by means of the modified USPHS criteria. After 6 months, the ‘combined bulk-fill’ technique resulted in the best performance of this study, followed by the ‘control’ and ‘bulk- fill’ techniques. The regular viscosity bulk-fill resin was extremely translucent, compromising the esthetic appearance of the restoration. Even so, new generation, bulk-fill resin composites show potential application for the restoration of tooth cavities of medium to greater depths.