Flexural strength of bulk-fill resin composites: A Bayesian hierarchical network meta-analysis.

IF 6.3 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Dental Materials Pub Date : 2026-05-01 DOI:10.1016/j.dental.2026.04.013

Ömer Hatipoğlu, Havva Nur Dinç, Matej Par, Fatma Pertek Hatipoğlu

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引用次数: 0

Abstract

Objectives: This study aimed to systematically synthesize existing in‑vitro data on clinical variability and mechanical performance differences of bulk‑fill materials.

Methods: PubMed, Scopus, and Web of Science were searched up to January 1, 2025. Inclusion criteria was restricted to peer-reviewed in-vitro studies evaluating direct resin composites intended for posterior use. Primary outcome was flexural strength (MPa). Treatment arms were hierarchically specified as composite classes (bulk-fill flowable, bulk-fill sculptable, fiber-reinforced, sonic/heat-activated, chemically activated/alkasite bulk-fill, and conventional sculptable) and their respective sub-brands. Results were synthesized through Bayesian hierarchical model.

Results: In total 44 studies (187 arms; 2134 specimens) were analyzed, with specimen numbers per arm ranging from 10 to 140. At class level, conventional sculptables ranked highest, followed by fiber-reinforced and sonic/heat-activated bulk-fills. Bulk-fill flowable and chemically activated/alkasite occupied the lowest ranks. Conventional sculptable demonstrated significant superiority to bulk-fill flowable and exhibited higher flexural strength relative to chemically/alkasite. At brand level; among conventional microhybrids, Grandio and Filtek Z250, among sculptable bulk-fills, Filtek One Bulk Fill Restorative and SonicFill, showed higher mean flexural-strength estimates. In contrast, flowable bulk‑fills such as Surefil SDR Flow and Tetric EvoFlow Bulk Fill tended to show lower values. Filtek One Bulk Fill Restorative demonstrated significantly higher flexural strength compared to SDR Flow and Tetric EvoFlow Bulk Fill. However, confidence in most class- and brand-level comparisons was rated as low or very low, primarily due to heterogeneity, indirectness, and imprecision.

Conclusion: While conventional composites generally outperformed bulk-fill composites, some sculptable bulk‑fills exhibited comparable strength. Due to high heterogeneity, current testing and reporting practices provide limited support for clinically meaningful differentiation among bulk-fill composite classes.

Significance: Flexural strength data in isolation are insufficient for product selection among bulk-fills; clinical decisions should rely on comprehensive evidence, including multiple in vitro properties and clinical performance data rather than single laboratory rankings.

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块体填充树脂复合材料的抗弯强度：贝叶斯层次网络元分析。

目的：本研究旨在系统地综合现有的体填充材料的临床变异性和力学性能差异的体外数据。方法：检索截止到2025年1月1日的PubMed、Scopus和Web of Science。纳入标准仅限于同行评审的体外研究，评估用于后路使用的直接树脂复合材料。主要终点是抗弯强度（MPa）。处理臂按层次划分为复合类别（可流动填充、可雕刻填充、纤维增强、声波/热激活、化学激活/碱石填充和常规雕刻填充）及其各自的子品牌。结果通过贝叶斯层次模型进行综合。结果：共分析44项研究（187个臂，2134个标本），每个臂的标本数量在10 ~ 140个之间。在班级水平上，常规雕塑排名最高，其次是纤维增强和声波/热激活的散装填充。散装填料可流动和化学活化/碱性磷酸钙排在最后。传统的可塑材料表现出明显的体积填充流动性优势，并表现出相对于化学/alkasite更高的抗弯强度。在品牌层面；在传统的微型混合材料中，Grandio和Filtek Z250，在可雕刻的散装填充材料中，Filtek One散装填充修复材料和SonicFill显示出更高的平均弯曲强度估计。相比之下，可流动的散装填料，如Surefil SDR Flow和Tetric EvoFlow散装填料，往往显示较低的值。与SDR Flow和Tetric EvoFlow Bulk Fill相比，Filtek One Bulk Fill Restorative具有更高的抗弯强度。然而，在大多数阶级和品牌水平的比较中，信心被评为低或非常低，主要是由于异质性、间接性和不精确。结论：虽然传统的复合材料通常优于大块填充材料，但一些可雕刻的大块填充材料表现出相当的强度。由于高度的异质性，目前的测试和报告实践对块状填充复合材料分类的临床有意义的区分提供有限的支持。意义：单独的抗折强度数据不足以用于散装填料的产品选择；临床决策应依靠综合证据，包括多种体外特性和临床表现数据，而不是单一实验室排名。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dental Materials 工程技术-材料科学：生物材料

CiteScore

9.80

自引率

10.00%

发文量

290

审稿时长

67 days

期刊介绍： Dental Materials publishes original research, review articles, and short communications. Academy of Dental Materials members click here to register for free access to Dental Materials online. The principal aim of Dental Materials is to promote rapid communication of scientific information between academia, industry, and the dental practitioner. Original Manuscripts on clinical and laboratory research of basic and applied character which focus on the properties or performance of dental materials or the reaction of host tissues to materials are given priority publication. Other acceptable topics include application technology in clinical dentistry and dental laboratory technology. Comprehensive reviews and editorial commentaries on pertinent subjects will be considered.