Comparative Evaluation of Bulk-Fill Composite Versus Conventional Composite During Restoration of Primary Teeth: A Systematic Review

Objectives: To evaluate the evidence available in clinical success of bulk-filled and conventional composite restoration in primary molars. Methods: A thorough search was conducted in PubMed, Cochrane, Google Scholar, and TRIP until December 2023 based on the inclusion and exclusion criteria. Randomized controlled trials using bulk-fill composite as one of the restorative materials were among the selection criteria. Four studies met the inclusion and exclusion criteria of the intended research. The search results were depicted in the PRISMA flow chart. The Cochrane collaboration’s risk-of-bias Assessment Tool 2.0 (RoB 2) was used to evaluate the RoB in the included studies. A meta-analysis was not feasible due to substantial heterogeneity among the studies, including differences in research design, participant selection, study duration, questionnaires, and diagnostic methods. Results: The initial search yielded 571 articles, but only four articles met the inclusion and exclusion criteria. All the four studies selected for systematic review compared the clinical success of bulk-filled and conventional composite restoration for primary molars. On assessing the RoB, one of the four included articles have a low RoB and three of the four included articles have high RoB due to uncertain or high risk in allocation concealment and blinding of participants. Conclusion: Based on the studies evaluated and the limitations of this review, a similar clinical performance of conventional resins and bulk resins for carious lesion restorations can be concluded.