Composite is an innovative material that has revolutionised the restorative dental field across the globe. It offers superior aesthetics and repairability compared to other filling materials on the market, while also presenting a cost-effective option for patients. Bulk fill solutions, in particular, have grown in popularity in recent years, providing time-saving benefits as well. To elevate treatment outcomes and ensure longer-lasting results, there are a number of steps that both the clinician and patient can implement.
Building on solid foundations
Composite resin has become a staple in the modern dentist’s armamentarium, having come into its own as the profession moves away from amalgam. This shift has been driven by a number of factors, including the Minamata Agreement in 2013 and evolving trends in the aesthetic expectations of patients.[i]
Thanks to growing demand, constant research and development, and a continued appetite for a greater choice of high-quality materials, there is now an array of composite solutions available for the dental practitioner to choose from. Many of these exhibit the aesthetics, strength, and wear resistance necessary to make them suitable for both anterior and posterior restorations.[ii] This has been especially important in the development of bulk fill composites, which now offer a time-efficient restorative option without compromising the quality of care. These materials have evolved to offer increased translucency and therefore better aesthetics, despite being built for speed and strength.[iii]
Today, the literature[iv] shows bulk fill composite to deliver a clinically effective restorative solution in primary teeth, with a retention rate of over 90% at one year and over 85% at two years. In terms of promoting time-efficiency, placement of the material often saves 2-4 minutes per restoration, which provides meaningful benefits for both clinician and patient. Evidence also shows no difference in clinical performance between bulk and conventional resins, highlighting the efficiency of various materials.[v]
Managing complications
Of course, the lower price-point and faster treatment time reflect the shorter lifespan of composite restorations. With regard to the estimated longevity of composite restorations, clinicians will often advise patients of a 2-5 year duration. The most common complications to arise in this time are chipping and fracture of the restorations, followed by caries. Research also indicates that direct restorations tend to last longer than indirect restorations in the mouth.[vi] However, the evidence confirms no statistically relevant differences in risk ratio between composite resin and amalgam, giving dentists confidence that this alternative restorative affords more than acceptable success rates.[vii]
Other complications that may require attention are secondary caries, marginal defects and staining, and wear. In addition, fracture of the adjacent teeth is possible in the presence of parafunctional activity or trauma, or due to polymerisation stresses at the time of placement.[viii] These risks can be minimised with comprehensive assessment and treatment planning to ensure the restoration is protected for as long as possible.
In the event of chipping or fracture, another significant further benefit of composite is the ease of its repair or replacement. The nature of composite means that material can simply be added to fill cracks or repair chips, repolished, and returned to its original aesthetic. Further serious damage can be easily rectified with removal of the remaining composite and replacement with a new direct restoration. These appointments are typically quick, affordable, and pain-free for the patient, while also still being minimally invasive.
Though further research is needed, initial findings suggest that repairing composite affords greater benefits than replacement where appropriate, which is good news for patient and practitioner alike.[ix]
Beyond professional intervention, maintenance of composite restorations is simple for patients. They need only implement an effective daily oral hygiene routine to remove plaque bacteria and reduce the risk of infection in the area that could compromise the restoration. This is important because secondary caries and elevated plaque scores are associated with higher restorative failure, especially in older patients.[x]
Maximising confidence
For maximum confidence in the restorations being placed, effective material selection is vital. The BRILLIANT EverGlow Bulk Fill from COLTENE offers an ideal solution that affords long-lasting aesthetics, optimal handling convenience, and high mechanical strength. Its unique filler technology makes it stable yet easily flowable for simple placement and dependable results. The innovative material can be placed and reliably cured in increments of up to 4mm in just 4 seconds, with no top layer needed for ultimate workflow efficiency.
With the right material and a comprehensive understanding of the potential complications associated with composite restorations, clinicians can optimise the chance of success and deliver exceptional patient care every day.
For more on COLTENE, visit https://colteneuk.com/BRILLIANT-EverGlow email info.uk@coltene.com or call 0800 254 5115.
Author: Vik Sharma – Sales Director Coltene Group
[i] European Parliamentary Research Service. Mercury: aligning EU legislation with Minamata. 2017. https://www.europarl.europa.eu/EPRS/EPRS-AaG-599309-Mercury-FINAL.pdf
[ii] Burke TFJ, Mackenzie L. A history of posterior composite restorations as viewed through the pages of Dental Update. Dental Update 2025 50:5, 401-410.
[iii] Kölüş T, Uçar AY. A Systematic Review and Meta-Analysis of the Success of Resin Composite Restorations. Journal of Advanced Oral Research. 2022;13(2):157-166. doi:10.1177/23202068221114979
[iv] Sarapultseva M, Hu D, Sarapultsev A. Clinical Performance of Bulk-Fill Versus Incremental Composite Restorations in Primary Teeth: A Systematic Review of In Vivo Evidence. Dent J (Basel). 2025 Jul 15;13(7):320. doi: 10.3390/dj13070320. PMID: 40710165; PMCID: PMC12294032.
[v] Arbildo-Vega HI, Lapinska B, Panda S, Lamas-Lara C, Khan AS, Lukomska-Szymanska M. Clinical Effectiveness of Bulk-Fill and Conventional Resin Composite Restorations: Systematic Review and Meta-Analysis. Polymers (Basel). 2020 Aug 10;12(8):1786. doi: 10.3390/polym12081786. PMID: 32785019; PMCID: PMC7464794.
[vi] Tennert C, Maliakal C, Suarèz Machado L, Jaeggi T, Meyer-Lueckel H, Wierichs Richard J. Longevity of posterior direct versus indirect composite restorations: A systematic review and meta-analysis. Dent Mater. 2024 Nov;40(11):e95-e101. doi: 10.1016/j.dental.2024.07.033. Epub 2024 Aug 9. PMID: 39122602.
[vii] Al-Sulimmani W, Al-Rasheed A, Al-Daraan H, Al-Mutairi M, Brahmbhatt Y, Al-Hazmi H, Al-Qaderi H. Failure Risk of Composite Resin and Amalgam Restorations: A Systematic Review and Meta-Analysis. Int Dent J. 2025 Aug;75(4):100871. doi: 10.1016/j.identj.2025.100871. Epub 2025 Jun 26. PMID: 40578032; PMCID: PMC12246595.
[viii] Blum IR, Lynch CD, Wilson NH. Factors influencing repair of dental restorations with resin composite. Clin Cosmet Investig Dent. 2014 Oct 17;6:81-7. doi: 10.2147/CCIDE.S53461. PMID: 25378952; PMCID: PMC4207439.
[ix] Abdulmohsen Al Rabiah, Alamri Zahrah, Tuwaym Malath, Al Daghri Ebtihal, Al Suhaibani Daniyah and Al Qahtani Abdullah (2021) “Dental Composite Restorations Repair: A Systematic Review and Meta-analysis”, Journal of Pharmaceutical Research International, 33(59A), pp. 707–738. doi: 10.9734/jpri/2021/v33i59A34322.
[x] Ulku SG, Unlu N. Factors influencing the longevity of posterior composite restorations: A dental university clinic study. Heliyon. 2024 Mar 8;10(6):e27735. doi: 10.1016/j.heliyon.2024.e27735. PMID: 38509902; PMCID: PMC10950679.
