Are you using bulk fill composites in your practice? Lee invites you to share your experiences, challenges, raves and results with bulk filling direct composite posterior restorations. Submit a comment below to weigh in.

 

 


Comments

Commenter's Profile Image Jim Landon
June 9th, 2010
I have been using Surefil's SDR for about 6 month now. I have not have any patients complain of post op problems. It saves time and I can still get good interproximal contacts. I cannot comment on its longevity or how things look 6 month later, YET. So far I really like it. I use it just as you described. Jim Landon D.D.S. Milwaukee, WI
Commenter's Profile Image Aly Sergie DDS
June 10th, 2010
I was completely against Bulk Fill composites - either Dual Cure or Light Cure ever since graduating my AEGD residency 3 years ago. The JADA's research wing publishes a REALITY-like comparison of restorative products and equipment - about twice every quarter. SUREFILL had very nice results in some of the most important categories. I've used Surefill on about 20 Cases - mostly for providing a buildup for endodontically treated and structurally compromised teeth. Obviously since the teeth have been treated endodontically - there is no sensitivity. It cuts nicely - slightly different from dentin but usually much sturdier than typical flowable. I still am not comfortable with the concept of using it underneath an occlusal layer of paste composite. In my head, it would appear as one interface too many.... Anyhow - it really only saves at most - 2-3 minutes MAX per tooth. My estimation is that people reading this blog, do not use 5 minute increments in booking their chair time. Aly Sergie DDS Dallas, TX
Commenter's Profile Image David Rowe Dmd, Magd
June 14th, 2010
Having spent considerable time with Dr's Ray Bertollotti and David Alleman with their concepts of biomimesis (mimicking natural tooth biology), this conversation would be their anti-christ. They routinely take 1 1/2 hrs to place a large restoration or an endodontic build up. They claim the science is clear in that the materials need the proper time to be cured as well as avoiding the shrinkage problems from polymerization. With that said, I have been using Filtek Supreme, Z 250, and Durafil for years using the bulk technique (no more than 2.5 mm at one cure). I have never had issues with sensitivity, bond failure, excess breakage, or difficulty in restoring contacts. I have not tried the Surefill like the previous responses. I would love to hear comments reguarding the newer materials as well as those who have used the bulk technique too. p.s.- I am a BLOG virgin, so please be kind to me and try not scare me away from future conversations
Commenter's Profile Image Will Kelly
June 14th, 2010
Both the surefill SDR and Voco grandio flow have been a routine part of my posterior composite fillings for over a year now. I enjoy the use of the flowable materials because of their handling. More importantly than saving time, I enjoy how they seem to "pull" themselves into place if you give them a second and can be manipulated with the syrienge tip. In fact, I commonly wait to give the assistant the green light to cure them in fear they might have not settled into place yet. I am skeptical of a true bulk fill but use a technique that stacks the material in diagonal planes from the floor of the prep to the margin. I fill in the "v" that remains with a traditional paste composite. I consider this a flowable application of incremental technique and find that the layers adapt better because they are "wetter" and require less manipulation. In very small occlusal restorations and am very comfortable bulk filling with Voco flowable which is 80% nano filled. It polishes well. I am skeptical of making marginal ridges in class two restorations from any bulk fill or flowables. All of this is just how I am using them....of course the manufactures will tell you that you could build the hoover dam out of their goo....but I really do like how the materials handle and hope that data suggests that they will be successful.
Commenter's Profile Image Lee Brady
June 14th, 2010
Thanks everyone for the responses. I must ad that everyone I have spoken to that is using these products has positive things to say. Let's keep the dialogue going.
Commenter's Profile Image Datta Malyav
June 16th, 2010
Agree with David Rowe. I have been doing bulk fill since 3 years. As long as I have less than 3mm I am ok. More than that 2 layers minimum. Many dentist have advocated this in the past. Currently I am using Gradia(GC america) and have excellent results with it.Only requirement is you need capsules, so you can inject it with the gun. I have tried both methods in the past. At present data i have in my practice is , at least adjust 1 restoration(post op sensitivity) a month out of 1600/year. Still do followup on all of them to see how they are doing. So bulk fill should work on the new ones too. I belive everything depends on your technique and curing light(1400mw of intensity and above). Welcome comments Datta
Commenter's Profile Image Aly Sergie DDS
April 7th, 2012
So it's almost 2 years now since my last post. There a tremendous amount of bulk fill products on the market now. It is a very confusing landscape. I do not use the the branded bulk-fill flowable types like Sur-Fil, Venus, or Grandio. I have had GREAT experience so far with Ivoclar's Bulk Fill Paste composite. I also use G-aenial Universal flowable composite for a tremendous amount of applications. In the past I have used, Sur-fil, venus, and Kerr's products. Sur-fil and venus are too translucent so if you are removing an alloy, you can get a gray looking filling unless you use a very opaque occlusal composite. Kerr's materials do not work well with how I place my composites. In other people's hand they may be ok, but the extra equipment is not worth it in my opinion. Most of my posterior work is now completed with Ivoclar's Bulk Fill Paste composite and a G-Aenial flow or universal flow - A2-Opaque. For Ivoclar Bulk fill - I have used the White, B-shade and A-shade. It looks pretty, handles wonderfully - when cured - it is like a ROCK. Very durable. We'll see how stain resistant it is. It is the perfect blend of opacity and translucence for almost any kind of posterior composite (composite replacement, alloy replacement, initial caries, etc....) Aly Sergie DDS