Comparison of the operative time and presence of voids of incremental and bulk-filling techniques on Class II composite restorations

Quintessence Int. 2022 Feb 1;53(3):200-208. doi: 10.3290/j.qi.b2218737.


Objectives: To compare the operative time and presence of air voids on Class II restorations fabricated by dental practitioners with 1 to 5 years of experience using incremental and bulk-filling techniques.

Method and materials: Four techniques were evaluated: incremental, bulk-filling, bulk-filling with heated composite, and snowplow technique. Standardized mandibular first molars with a MOD (mesial, occlusal, and distal) cavity were used. Voluntary operators made two restorations using each technique and the time required for each restoration was recorded. The restorations were scanned by micro-computed tomography to calculate the volume of the restoration occupied by air voids. The "operative time" and "volume of air voids" were analyzed individually by two-way ANOVA and Tukey HSD post hoc (α = .05) for the factors operator and insertion technique. A correlation between "operative time" and "volume of air voids" was evaluated using Pearson coefficient (α = .05).

Results: The incremental technique required significantly longer time, yet no differences were observed between the bulk-filling techniques. There were no significant differences between techniques regarding the volume of air voids. A significant, but weak, and inverse linear correlation (P = .0059; r = -.29; r2 = 8.41%) was found between the operative time and volume of air voids.

Conclusion: There were no significant differences in the volume of air voids among the evaluated techniques, although bulk-filling techniques required a shorter operative time. Hence, implementing bulk-filling techniques by dental schools and restorative dental practitioners with different levels of expertise may reduce chair time and produce a volume of air voids similar to the incremental technique.

Keywords: composite resins; computed tomography; dental materials; dental restoration; filling materials; operative dentistry.

MeSH terms

  • Composite Resins*
  • Dental Cavity Preparation
  • Dental Restoration, Permanent*
  • Dentists
  • Humans
  • Materials Testing
  • Operative Time
  • Professional Role
  • X-Ray Microtomography


  • Composite Resins