Bulk fills are light-cured dental composites that require fewer layers than conventional composites. Bulk fill composites have seen a rapid rise in popularity over the years as new formulations have made the material translucent enough to allow curing lights to reliably penetrate material as thick as 5mm. This results in a reduction in time of material placement and polymerisation, while many dentists prefer using fewer layers to reduce risk of air pockets and voids. Bulk-fill composites are mostly indicated for Class I and II posterior restorations.

Coming pre-packed in a syringe for quick use, flowable composites are known for their excellent handling properties as they are made up of a lower filler content therefore lower viscosity. This increased fluidity allows flowables to be used in tight or small indications as the material flows into the small recesses of a preparation more easily than a thicker composite would. To negate some of the disadvantages of flowable composites, such as the greater likelihood of polymerisation shrinkage, a lot of flowables are now formed with higher filler content for added strength.

The oldest subtype of resin composite, universal composite is associated with being versatile enough to cover most restoration types, both anterior and posterior. This adaptable material is designed for both indirect and direct restorations, and is applied in incremental layers. Though not as quick to apply as bulk-fills, conventional composites remain extremely popular due to their well-documented clinical performance. Indications include the restoration of class I, II and III and IV.

Aside from ease of handling and reducing patient time, delivering a satisfactory aesthetic finish may be the most important requirement of a composite for dentists. To mimic the true shade of the restoration and surrounding teeth, many dental practices stock a flexible range of composite shades. Many brands make this easy by offering a range of 20+ variety of shades of enamel and dentine as either full kits or individuals in accordance with their own shade guides or the Vita classical A1-D4 shade guide. The there are also outstanding composites that offer dual shading, such as the DEHP Nanohybrid Composite, which is perfect for dentists who want consistent results without having to store too many variants.

Polymerisations contraction, or shrinkage as its more commonly known, is an inevitable part of restorations and can lead to staining, microleakage and secondary caries among other problems. Though it’s impossible to completely remove any chances of this happening, this does not mean different composite materials and techniques can and should be carefully selected to reduce any likelihood. Bulk fills, such as SDR Flow+ from Dentsply, which uses technology to enable a more relaxed polymerisation process, is a favourite of dentists when it comes to trying to minimise shrinkage.

When it comes to composite bonding, manufacturers often prefer dentists to use the same brand of composite and adhesive. However, if you can find a bonding agent that is compatible and easy to use, there’s no reason it cannot be used more flexibly.

3M Scotchbond Universal Plus is a prime example of such an adhesive as it can bond to all composite fillings and is suitable for adhesion to all dental substrates without the need for a separate primer, silane or activator. Radiopacity is also an important factor to also look out for when deciding which composites to stock. Using a dental composite that is radiopaque, such as Venus Pearl and Charisma ABC, allows x-rays to distinguish between composite and natural tooth more easily, thus aiding the diagnosis of defects like fractures, voids, marginal problems, secondary caries and over-contouring.