Solving color irregularities with a bioactive bulk-fill restorative system: Case report and 24-months follow up.

  • Fernando Grandon Departamento de Odontología Restauradora, Facultad de Odontología, Universidad de Concepción, Chile.
  • Maria Muster Facultad de Odontología, Universidad Andrés Bello, Chile.
  • Michael Wendler Departamento de Odontología Restauradora, Facultad de Odontología, Universidad de Concepción, Chile.


Bulk-fill resin composites represent an excellent alternative to the conventional incremental layering technique for the reduction of polymerization stress on the adhesive interface. Marginal seal can be further improved by the incorporation of bioactive fillers, such as those encountered in Giomers. However, the high translucency required for the adequate polymerization of bulk-fill materials can seriously jeopardize the final aesthetic outcome of the restorations, especially in the presence of inhomogeneous or stained dentin substrates. The aim of this case report was to present the combined use of two bulk-fill Giomer materials (Beautifil Bulk Flowable and Beautifil II LS, Shofu) for the restoration of three posterior maxillary teeth displaying a black stained dentin substrate due to amalgam corrosion products. This technique allowed completion of the restorations with a satisfactory aesthetic and biomimetic outcome. The adequate preservation of the anatomy and function of the three restorations after 24-months follow-up, provides evidence of the enhanced marginal sealing capacity of these bioactive materials and the success of bulk-fill techniques over time.


[1]. Ferracane JL. Resin composite - State of the art. Dent Mater. 2011;27(1):29–38.

[2]. Bicalho AA, Valdívia ADCM, Barreto BCF, Tantbirojn D, Versluis A, Soares CJ. Incremental filling technique and composite material-Part II: Shrinkage and shrinkage stresses. Oper Dent. 2014;39(2):83–92.

[3]. van Ende A, de Munck J, Lise DP, van Meerbeek B. Bulk-fill composites: A review of the current literature. J Adhes Dent. 2017;19(2):95–109.

[4]. Yazici AR, Antonson SA, Kutuk ZB, Ergin E. Thirty-six-month clinical comparison of bulk fill and nanofill composite restorations. Oper Dent. 2017;42(5):478–85.

[5]. Lima RBW, Troconis CCM, Moreno MBP, Murillo-Gómez F, De Goes MF. Depth of cure of bulk fill resin composites: A systematic review. J Esthet Restor Dent. 2018;30(6):492–501.

[6]. Cidreira Boaro LC, Pereira Lopes D, de Souza ASC, Lie Nakano E, Ayala Perez MD, Pfeifer CS, et al. Clinical performance and chemical-physical properties of bulk fill composites resin —a systematic review and meta-analysis. Dent Mater. 2019;35(10):e249–64.

[7]. van Dijken JWV, Pallesen U. Posterior bulk-filled resin composite restorations: A 5-year randomized controlled clinical study. J Dent. 2016;51:29–35.

[8]. van Dijken JWV, Pallesen U. Bulk-filled posterior resin restorations based on stress-decreasing resin technology: a randomized, controlled 6-year evaluation. Eur J Oral Sci. 2017;125(4):303–9.

[9]. Reis AF, Vestphal M, do Amaral RC, Rodrigues JA, Roulet JF, Roscoe MG. Efficiency of polymerization of bulk-fill composite resins: A systematic review. Braz Oral Res. 2017;31:37–48.

[10]. Barutcigil Ç, Barutcigil K, Özarslan MM, Dündar A, Yilmaz B. Color of bulk-fill composite resin restorative materials. J Esthet Restor Dent. 2018;30(2):E3‐E8.

[11]. Ilie N, Stawarczyk B. Evaluation of modern bioactive restoratives for bulk-fill placement. J Dent. 2016;49(2016):46–53.

[12]. Rusnac ME, Gasparik C, Irimie AI, Grecu AG, Mesaroş AŞ, Dudea D. Giomers in dentistry - at the boundary between dental composites and glass-ionomers. Med Pharm Reports. 2019;92(2):1–6.

[13]. Scholtanus JD, Özcan M, Huysmans MCDNJM. Penetration of amalgam constituents into dentine. J Dent. 2009;37(5):366–73.

[14]. Hirata R, Kabbach W, De Andrade OS, Bonfante EA, Giannini M, Coelho PG. Bulk Fill Composites: An Anatomic Sculpting Technique. J Esthet Restor Dent. 2015;27(6):335–43.

[15]. Opdam NJM, Van De Sande FH, Bronkhorst E, Cenci MS, Bottenberg P, Pallesen U, et al. Longevity of posterior composite restorations: A systematic review and meta-analysis. J Dent Res. 2014;93(10):943–9.

[16]. Ilie N, Fleming GJP. In vitro comparison of polymerisation kinetics and the micro-mechanical properties of low and high viscosity giomers and RBC materials. J Dent. 2015;43(7):814–22.

[17]. Kurokawa H, Takamizawa T, Rikuta A, Tsubota K, Miyazaki M. Three-year clinical evaluation of posterior composite restorations placed with a single-step self-etch adhesive. J Oral Sci. 2015;57(2):101–8.

[18]. Gordan VV, Blaser PK, Ronald E, Mjör IA, Mcedward DL, Sensi LG, Riley III JL. A clinical evaluation of a giomer restorative sistema containing surface prereacted glass ionomer filler. J Am Dent Assoc. 2014;145(10):1036-43.

[19]. Durán Ojeda G, Henríquez Gutiérrez I, Tisi JP, Báez Rosales A. A Novel Technique for Bulk-Fill Resin-Based Restorations: Achieving Function and Esthetics in Posterior Teeth. Case Rep Dent. 2017;2017:1-5.

[20]. Guo Y, Landis FA, Wang Z, Bai D, Jiang L, Chiang MYM. Polymerization stress evolution of a bulk-fill flowable composite under different compliances. Dent Mater 2016;32(4):578–86.
How to Cite
GRANDON, Fernando; MUSTER, Maria; WENDLER, Michael. Solving color irregularities with a bioactive bulk-fill restorative system: Case report and 24-months follow up.. Journal of Oral Research, [S.l.], v. 9, n. 5, p. 430-436, oct. 2020. ISSN 0719-2479. Available at: <>. Date accessed: 08 feb. 2023. doi: