Sarapultseva Maria, Hu Desheng, Sarapultsev Alexey
Department of Pediatric Dentistry, Medical Firm Vital EVV, Ekaterinburg 620144, Russia.
Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Dent J (Basel). 2025 Jul 15;13(7):320. doi: 10.3390/dj13070320.
: This is the first systematic review to focus exclusively on in vivo randomized controlled trials that compare bulk-fill and conventional incremental composite restorations in primary teeth. Our aim was to synthesize current evidence on their clinical performance, including retention, two-year survival rates, marginal integrity, and procedural efficiency. : A comprehensive literature search was conducted in PubMed, Scopus, and the Elicit AI platform up to March 2025. Eligible studies were in vivo randomized controlled trials involving children aged 3-12 years with carious primary teeth, directly comparing bulk-fill and incremental composite restorations. Primary outcomes included retention rates, two-year survival, and marginal integrity, while secondary outcomes were postoperative sensitivity, secondary caries, and aesthetic outcomes. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessments using the Cochrane RoB 2.0 tool. A narrative synthesis was undertaken due to substantial heterogeneity in study design and outcome reporting. The review protocol was registered in PROSPERO (CRD420251021433). : Thirteen randomized controlled trials met the inclusion criteria. Both restoration techniques demonstrated high short-term retention rates (>90%) and comparable two-year survival (85-90%). Marginal integrity was generally equivalent, though incremental techniques showed modest advantages in complex cavities. Secondary outcomes were inconsistently reported, with no significant group differences. Bulk-fill restorations consistently reduced the procedural time by 2-4 min per restoration, representing a meaningful advantage in pediatric clinical settings. : Bulk-fill composites offer a clinically effective and time-efficient alternative to incremental layering in the restoration of primary teeth. This focused synthesis addresses a gap in existing reviews by concentrating solely on primary dentition and in vivo evidence. Despite similar clinical outcomes, the time savings associated with bulk-fill techniques may enhance their utility in pediatric dentistry. Further standardized and long-term trials are warranted to confirm these findings and inform clinical guidelines.
这是第一项专门聚焦于比较乳牙大块充填式和传统分层复合树脂修复体的体内随机对照试验的系统评价。我们的目的是综合目前关于它们临床性能的证据，包括固位、两年生存率、边缘完整性和操作效率。
截至2025年3月，在PubMed、Scopus和Elicit AI平台上进行了全面的文献检索。符合条件的研究是涉及3至12岁患有龋齿乳牙儿童的体内随机对照试验，直接比较大块充填式和分层复合树脂修复体。主要结局包括固位率、两年生存率和边缘完整性，而次要结局是术后敏感性、继发龋和美学效果。两名评价者使用Cochrane RoB 2.0工具独立进行研究选择、数据提取和偏倚风险评估。由于研究设计和结局报告存在实质性异质性，因此进行了叙述性综合分析。该评价方案已在PROSPERO（CRD420251021433）注册。
十三项随机对照试验符合纳入标准。两种修复技术均显示出较高的短期固位率（>90%）和相当的两年生存率（85-90%）。边缘完整性总体相当，尽管分层技术在复杂窝洞中有适度优势。次要结局报告不一致，组间无显著差异。大块充填式修复体每次修复始终将操作时间减少2-4分钟，这在儿科临床环境中具有显著优势。
大块充填式复合树脂在乳牙修复中为分层充填提供了一种临床有效且节省时间的替代方法。这项重点综合分析仅关注乳牙列和体内证据，填补了现有综述中的空白。尽管临床结局相似，但与大块充填技术相关的时间节省可能会提高其在儿童牙科中的实用性。需要进一步进行标准化的长期试验来证实这些发现并为临床指南提供依据。
