Comparison of Internal Adaptation of Bulk-fill and Increment-fill Resin Composite Materials

Objectives: To evaluate 1) the internal adaptation of a light-activated incremental-fill and bulk-fill resin-based composite (RBC) materials by measuring the gap between the restorative material and the tooth structure and 2) the aging effect on internal adaptation. Methods and materials: Seventy teeth with class I cavity preparations were randomly distributed into five groups; four groups were restored with bulk-fill RBCs: Tetric EvoCeram Bulk Fill (TEC), SonicFill (SF), QuiXX Posterior Restorative (QX), and X-tra fil (XF); the fifth group was restored with incremental-fill Filtek Supreme Ultra Universal Restorative (FSU). One-half of the specimens of each group were thermocycled. Each tooth was sectioned, digital images were recorded, and the dimensions of any existing gaps were measured. Data were analyzed using analysis of variance (alpha=0.05). Results: FSU had the smallest gap measurement values compared with the bulk-fill materials except QX and TEC (p <= 0.008). FSU had the smallest sum of all gap category values compared with the bulk-fill materials, except QX (p <= 0.021). The highest gap incidence and size values were found at the composite/adhesive interface. All aged groups had greater gap values in regard to the gap measurement and the sum of all gap categories compared with non-aged groups. Significance: The incrementally placed material FSU had the highest internal adaptation to the cavity surface, while the four bulk-fill materials showed varied results. Thermocycling influenced the existing gap area magnitudes. The findings suggest that the incremental-fill technique produces better internal adaptation than the bulk-fill technique.