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    How to decrease chair time and sensitivity with reliable bulk fill restoratives

    Using bulk fill resin composites can produce less volumetric polymerization shrinkage.

    Incremental Layering has been the technique indicated when dealing with light-cured resin composites for many years. The main reasons of this occurrence are because it was observed that resin composites lose light energy with increased depth (meaning, the bottom of each layer receives less light when compared to the top)1; and because resin composites suffer from polymerization shrinkage when they are light-cured2,3,4.

    However, resin material improvements have led to a different level of strategy, and nowadays, with the use of some newer composites known as bulk fills, the incremental layer is no longer the only option available.

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    Bulk fill composites are materials with a chemically modified composition in either their fillers, organic matrix, photoinitiators, or a combination of them, allowing them to be light-cured up to 4-5 mm increments, depending on the material used, with reduced volumetric shrinkage and stress2,3,4. Volumetric shrinkage is an unavoidable characteristic of all resin-based materials, due to the reduction of distance between monomer molecules as a result of van der Waals forces when polymerization occurs, producing a reduced free volume densely packed polymer5,6.

    Polymerization shrinkage might lead to gaps at the interface, tooth and composite fractures, and postoperative sensitivity, among others7,8.

    Besides showing equal or less volumetric shrinkage2,4, bulk fill composites also present the advantage of allowing for a friendlier procedure, simplifying cavity filling, as well as being a time-saving and less sensitive procedure when compared to the incremental technique9, which is known for implementing voids in between layers, and is only completed after several composite resin layers and light-curing cycles.

    This case report used a regular consistency bulk fill resin composite (Tetric EvoCeram Bulk Fill, Ivoclar Vivadent), that showed, by micro-computed tomography, to produce less volumetric polymerization shrinkage when compared to conventional resin composites and other bulk fill resin composites2, thus showing good scientific results and validating its safe application in the mouth.

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