Filtek Bulk Fill

Posterior Restorative

Technical Product Profile

 Table of Contents

Table of Contents
Introduction......................................................................................... 3
Product Description............................................................................. 4
Product Features................................................................................. 4
Indications for Use............................................................................... 4
Composition........................................................................................ 5
Shades................................................................................................ 5
Background......................................................................................... 6
Resin System.............................................................................................. 6-7
Fillers.............................................................................................................. 7
Physical Properties.............................................................................. 8
Depth of Cure............................................................................................ 9-11
Shrinkage Stress........................................................................................... 12
Cusp Deflection............................................................................................. 12
Flexural Modulus........................................................................................... 13
In-vitro, 3-Body Wear.................................................................................... 14
Polish Retention......................................................................................14-15
Fracture Toughness....................................................................................... 16
Flexural Strength and Compressive Strength................................................. 17
Questions and Answers................................................................19-22
References........................................................................................ 23

2
 Introduction

Introduction
Since the introduction of light curable composites, dentists have been required to place the material in
increments. These composites require light (in the proper wavelength) to excite a photo-initiator, which begins
the polymerization process. If the light penetration is insufficient, poor initiation of this reaction can result, which
can lead to under-cured or uncured material. The depth of cure of a composite is determined by the monomers,
the initiators and the shade/opacity of the material. Additionally, the effectiveness of the light is influenced by
many factors including the wavelength, the light intensity, the distance from the light source, and the exposure
time. Dentists use incremental placement techniques for a variety of reasons in addition to the cure depth of
the composite. Incremental placement is used to manage the shrinkage and corresponding shrinkage stress,
resulting from the polymerization reaction. Incremental placement allows for more precise manipulation of the
restorative to ensure adaptation, particularly at the cavosurface. It reduces the possibility of voids and aids in
forming contacts and sculpting the occlusal surface prior to cure. Managing the shrinkage stress and ensuring
proper adaptation may reduce the incidence of post-operative sensitivity. Additionally, incremental placement
readily lends itself to creating multi-shade restorations.

On the other hand, incremental placement is considered time consuming and tedious, especially in posterior
teeth. Increments may increase the potential of voids to form between composite layers, and composites must
be placed in a dry field. The risk of contamination leading to a compromised restoration is adversely impacted
by the time it takes to place, adapt and cure each increment.

In an effort to provide materials that address the challenges of incremental placement, and also provide an
alternative material to amalgam, packables were launched in the late 1990s. These materials had a high
viscosity and contained a high filler load. Manufacturers claimed the handling was amalgam-like and the
material stiffness aided in forming contacts. In addition, many of the packables were reported to have the
capability of being bulk placed, i.e., to be placed and cured in 4-5 mm increments. However, the high viscosity
of these composites made adaptation to the cavosurface more challenging.1,2 The actual depth of cure of
these materials was found to be less than claimed.3 Even if the adequacy of cure was acceptable, the clinical
ramifications of shrinkage stress became more prominent with thicker (4-5 mm) layers. Studies have shown
that many of these materials still had high shrinkage and polymerization stress.

The field of materials science has made remarkable advancements with composite filling materials used for
direct procedures, which offer dentists solutions to many of the issues that they see every day. It is pretty
widely understood in the scientific and dental communities that bulk filling a restoration increases stresses on
the tooth, and can decrease bond strength. However, with the capabilities of materials currently available to
manufacturers, it is possible to create materials/products that offer lower polymerization shrinkage stress when
compared to incrementally placed composites.

3
 Product Description

Product Description
3M™ ESPE™ Filtek™ Bulk Fill Posterior Restorative material is a visible, light-activated restorative composite
optimized to create posterior restorations simpler and faster. This bulk fill material provides excellent strength
and low wear for durability. The shades are semi-translucent and low-stress curing, enabling up to a 5 mm
depth of cure. With excellent polish retention, Filtek Bulk Fill Posterior Restorative is also suitable for anterior
restorations that call for a semi-translucent shade. All shades are radiopaque. Filtek Bulk Fill Posterior Restorative
is offered in A1, A2, A3, B1 and C2 shades.

Product Features
• Packaged in 0.2 gram capsules and 4.0 gram syringes

­ - Syringes are dark teal green with white labels and shade designations

­ - Capsules are black with dark teal green caps

• 5 Shades – A1, A2, A3, B1, C2

• Class II 5 mm depth of cure for all shades

Indications for Use

• Direct anterior and posterior restorations (including occlusal surfaces)

• Base/liner under direct restorations

• Core build-ups

• Splinting

• Indirect restorations including inlays, onlays and veneers

• Restorations of deciduous teeth

• Extended fissure sealing in molars and premolars

• Repair of defects in porcelain restorations, enamel and temporaries

4
 Composition

Composition
The fillers are a combination of a non-agglomerated/non-aggregated 20 nm silica filler, a non-agglomerated/
non-aggregated 4 to 11 nm zirconia filler, an aggregated zirconia/silica cluster filler (comprised of 20 nm silica
and 4 to 11 nm zirconia particles) and a ytterbium trifluoride filler consisting of agglomerate 100 nm particles. The
inorganic filler loading is about 76.5% by weight (58.4% by volume). Filtek™ Bulk Fill Posterior Restorative contains
AUDMA, UDMA and 1, 12-dodecane-DMA. Filtek Bulk Fill Posterior Restorative is applied to the tooth following
use of a methacrylate-based dental adhesive, such as manufactured by 3M, which permanently bonds the
restoration to the tooth structure. Filtek Bulk Fill Posterior Restorative is packaged in traditional syringes and
single-dose capsules.

Shades
Filtek Bulk Fill Posterior Restorative material is available in 5 shades: A1, A2, A3, B1 and C2. These shades are more
translucent than the body or enamel shades of other universal composites.

A1 A2 A3 Figure 1:
Source: 3M internal data

B1 C2

5
 Background

Background
Resin System
The primary aim of this development effort was to design a material that would allow a practitioner to place
and cure a 5 mm deep restoration up to occlusion. In order to accomplish this task, many aspects of the
resin system needed to be considered. One of the primary considerations in designing this resin system was
the ability to relieve the amount of shrinkage stress upon light curing. Additionally, because this is a bulk fill
material, the depth of cure of the material was a key property considered during development. Unlike many of
the flowable composites on the market, this material was designed to be filled up to occlusion, so attaining high
wear resistance was a central effort. Another key factor that had to be considered for a material that will be
filled in bulk was optimized handling and enhanced adaptation to the cavity preparation.

Methacrylate composites have an inherent tendency to shrink during polymerization and can shrink to
varying degrees depending on the monomers being used. Filtek™ Bulk Fill Posterior Restorative contains two
novel methacrylate monomers that, in combination, act to lower polymerization stress. One monomer, a high
molecular weight aromatic dimethacrylate (AUDMA) (Figure 2), decreases the number of reactive groups in
the resin. This helps to moderate the volumetric shrinkage as well as the stiffness of the developing and final
polymer matrix—both of which contribute to the development of polymerization stress.

Figure 2: AUDMA
Structure
Source: 3M internal data

The second unique methacrylate represents a class of compounds called addition-fragmentation monomers (AFM)
(Figure 3). During polymerization, AFM reacts into the developing polymer as with any methacrylate, including
the formation of cross-links between adjacent polymer chains. AFM contains a third reactive site that cleaves
through a fragmentation process during polymerization. This process provides a mechanism for the relaxation of
the developing network and subsequent stress relief. The fragments, however, still retain the capability to react
with each other or with other reactive sites of the developing polymer. In this manner, stress relief is possible while
maintaining the physical properties of the polymer.

Figure 3: AFM
Structure
Source: 3M internal data

6
 Background

DDDMA (1, 12-Dodecanediol dimethacrylate) (Figure 4) has a hydrophobic backbone that increases its molecular
mobility and compatibility with nonpolar resins. DDDMA offers a low viscosity/low volatility resin that is commonly
used in biomaterials and dental applications due in part to its fast cure with low exotherm and low shrinkage. This is
a high-modulus resin with good flexibility and impact resistance.

Figure 4: DDDMA Structure

Source: 3M internal data

UDMA (urethane dimethacrylate) (Figure 5) is a relatively low-viscosity, high-molecular weight monomer.

This monomer was included in the resin system to reduce the viscosity of the resin.

Figure 5: UDMA Structure

Source: 3M internal data

Additionally, the higher molecular weight effectively reduces the shrinkage while still creating a tough, highly
cross-linked network.
By modifying the proportions of these high molecular weight monomers, a resin system with the properties of a
sculptable bulk fill material was developed. The resin system also produces polymerization shrinkage stress relief
and a depth of cure of 5 mm.

Fillers
The fillers included in Filtek™ Bulk Fill Posterior Restorative were designed to maximize strength, wear resistance
and radiopacity while minimizing shrinkage and maintaining good handling. The filler system in Filtek Bulk Fill
Posterior Restorative is the same system found in Filtek™ Supreme Ultra Universal Restorative, with the important
addition of agglomerate 100 nm Ytterbium trifluoride (YbF3) particles for increased radiopacity. The remaining fillers
are a combination of a non-agglomerated/non-aggregated 20 nm silica filler, a non-agglomerated/non-aggregated
4 to 11 nm zirconia filler, an aggregated zirconia/silica cluster filler (comprised of 20 nm silica and 4 to 11 nm
zirconia particles), making the total inorganic filler loading approximately 76.5% by weight (58.4% by volume).

7
 Physical Properties

Physical Properties
4mm Depth of Cure
Several methods are available for characterizing the extent of polymerization of light-cured dental composite
filling materials. One is the “scrape-back” method, which is the basis of the depth-of-cure method described
by ISO 4049:2009. In this ISO standard, the uncured composite is placed in a cylindrical-shaped stainless steel
mold and light cured from one end of the mold. The composite is immediately extracted from the mold and the
unpolymerized or low-polymerized composite is scraped off the end farthest from the light. The length of the
remaining “cured” composite is measured and divided by a factor of 2. This length is typically rounded to the
closest integer value and claimed as the depth of cure. This follows from the ISO 4049 specification, which allows
a claimed depth of cure 0.5 mm greater than half the scrape-back measurement. It has been shown that the
extent of polymerization throughout this length decreases from the end closest to the light (where light intensity
was greatest) to the end where the uncured material was scraped off [4]. It was also shown in [4] that the extent of
polymerization at half the scraped-back length is approximately 90% of the maximum polymerization.

Depth of cure for the indicated shades of Filtek™ Bulk Fill Posterior Restorative measured using the
ISO 4049 standard and a 20-second cure with the Elipar™ S10 LED Curing Light using its 10 mm light guide
are shown below (Table 1).

Shade Avg. Depth (mm) Std. Dev.

A1 4.56 0.09

A2 4.29 0.10

A3 4.40 0.06

B1 4.24 0.04

C2 4.39 0.06

Table 1. ISO 4049 Depth of Cure – Filtek™ Bulk Fill Posterior Restorative. 20s exposure,
Elipar™ S10 LED Curing Light

Another common method for assessing extent of polymerization is microhardness testing, which has been shown
to correlate with the extent of polymerization [5]. As in the ISO method, it is typical to place the uncured composite
in some type of mold and light cure from one end of the mold. This sample is then extracted and the hardness is
measured along its length. Rather than reporting the actual hardness value measured, it is more meaningful to
represent the hardness at any given point within the sample as a percentage of the maximum hardness attained.
It has been shown with a variety of different composites that 80% of the maximum hardness was associated with
90% of the maximum polymerization [6].

8
 Physical Properties

The clinical significance of both tests as described above is not known. In other words, the extent of polymerization that
is needed for a durable restoration has not been determined. Some investigators have suggested 80% of maximum
microhardness (equivalent to half the scraped-back length as defined by the ISO standard) as a minimum threshold
[4,5]. This recommended threshold, however, is not based on clinical studies or laboratory models involving extracted
teeth. Recent laboratory studies involving extracted human teeth have suggested a lower limit of polymerization at 73%
of maximum microhardness or 80% of maximum polymerization [6].

5mm Depth of Cure

(ex vivo tooth model)
Oregon Health & Science University

The depth of cure of Filtek™ Bulk Fill Posterior Restorative prototypes was investigated in Class II slot preparations in
extracted molars at the Oregon Health & Science University. The experimental tooth was placed in a simulated arch
between two adjacent teeth. The depth of the preparation was 5 mm to the gingival floor with a 3 or 7 mm width
and 2 mm depth (Figure 6).

1. 2. Extract restoration
Center
Band Axial

5mm
deep

7m
m 2mm

• Class II Slot Preparation in molar

tooth not tapered Figure 6:
Source: Oregon Health &
• Metal matrix Science University

3. Cut restoration through middle 4. Measure Knoop Microhardness

in the mesial-distal direction a) along band side, b) down middle, c) along axial side of
tooth in 1 mm increments starting 0.1 mm from top and
0.5 mm within the band and tooth side surfaces.
0.1mm
1.1
Tooth Side
Band Side

2.1
3.1
4.1
5.1

9
 Physical Properties

Prior to placement, the preparation was lightly coated with petroleum jelly to facilitate extraction of the restoration.
A circumferential metal Tofflemire matrix was applied and the composite was placed in one 5 mm increment and light
cured either with a single or a multi-sited exposure with an Elipar™ S10 LED Curing Light. The curing lamp
was measured to have an output of 1,000mW/cm2. After curing, the restorations were recovered and sectioned
mesiodistally. Microhardness was then measured at three locations down the length of the restorations—1)
0.2 mm within the composite adjacent to the matrix band, 2) down through the center of the restoration, and
3) 0.2 mm within the composite adjacent to the axial face of the preparation (Figure 7). Three pastes differing in
opacity were investigated. The results obtained with the paste with the highest opacity, which most resembles the final
prototype, are presented below. Twelve replicates were run for each exposure condition.

Figure 7 reveals a spatial dependence of cure at the deepest (5.1 mm) portion of the restoration with the hardness
adjacent to the metal matrix band exhibiting the lowest value. It is also apparent that the hardness does not meet
the 80% threshold at any of the locations measured at this depth. At 4.1 mm depth, the interfacial hardness adjacent
to the tooth is comparable to that at the middle of the restoration, while the hardness adjacent to the matrix band
is suppressed below the 80% threshold. While the curing conditions are not sufficient to meet the threshold cure
throughout the Class II restoration at a depth of 4 mm, the results support a sufficient exposure for a 4 mm depth of
cure in a Class I restoration where, based on these results, the extent of cure at the tooth-composite interface and down
the middle of the restoration are similar.

Figure 7: Hardness versus 70.0

depth. 20-second
occlusal cure,
1000mWcm-2, 60.0
7 mm diameter- 80% of
wide restoration 50.0 maximum
Knoop Hardness

Source: Oregon Health & hardness

Science University
40.0
0.2mm Tofflemire
30.0
Middle
20.0
0.2mm tooth edge
10.0

0.0
0.0 1.0 2.0 3.0 4.0 5.0 6.0
Depth / mm

70.0

60.0

50.0
Hardness

10
40.0 80% of
maximum
 60.0 0.2mm Tofflemire
30.0
Knoop
80% of
Knoop Hardness 50.0 Middle maximum
20.0 hardness
40.0 0.2mm tooth edge Physical Properties
10.0
0.2mm Tofflemire
30.0
0.0 Middle
20.00.0 1.0 2.0 3.0 4.0 5.0 6.0
0.2mm
An alternative, multi-sited toothprotocol
curing edge has beenDepthshown
/ mmto be effective for bulk light-cured composite materials in
10.0
Class II restorations made in extracted human teeth [10]. In this investigation, the restoration was first exposed with the
light
0.0 from the occlusal surface followed by subsequent exposures from the buccal and lingual surfaces. This multi-sited
approach
0.0 was shown1.0 to be effective 2.0
in obtaining a 53.0
mm depth of cure
4.0 in the Class 5.0
II restoration using
6.0the prototype
composite as shown in Figure 8. In this case, the protocol included a 10-second occlusal cure and an additional
Depth / mm
10-second cure from both the mesio-buccal and linguo-buccal directions after removing the matrix band. Since the
attenuation of light through tooth mineral is likely greater than that through the prototype composite (Figure 8), the
70.0
multi-sited cure technique was duplicated for a 3 mm diameter-wide restoration, thereby creating a greater curing
challenge.
60.0 The results are depicted in Figure 9. In both cases, the multi-sited curing technique was effective in achieving
the threshold of 80% maximum hardness.
50.0
70.0 Hybrid Layer
Knoop Hardness

Figure 8: Hardness versus

depth. 10s occlusal/
40.0 80% of 10s mesio-buccal/
60.0 maximum 10s linguo-buccal,
hardness 7 mm diameter
30.0 restoration,
50.0 0.2mm tooth edge
1000mWcm-2
Knoop Hardness

20.0 Middle Source: Oregon Health &

40.0 80% of Science University

10.0 0.2mm Tofflemire maximum

30.0 hardness
0.2mm tooth edge
0.0
20.0 Middle
0.0 1.0 2.0 3.0 4.0 5.0 6.0

10.0 0.2mm Tofflemire Depth / mm

0.0
0.0 1.0 2.0 3.0 4.0 5.0 6.0
Depth / mm

60.0 Figure 9: Hardness versus

depth. 10s occlusal/
10s mesio-buccal/
50.0 10s linguo-buccal,
3 mm diameter
restoration,
1000mWcm-2
40.0
60.0
Knoop Hardness

80% of Source: Oregon Health &

Hybrid Layer maximum Science University
30.0
50.0 0.2mm tooth edge hardness

20.0 Middle
40.0
Knoop Hardness

80% of
0.2mm Tofflemire maximum
10.0
30.0 0.2mm tooth edge hardness

0.0
20.0 Middle
0.0 1.0 0.2mm2.0
Tofflemire 3.0 4.0 5.0 6.0
10.0 Depth / mm
11
0.0
 Physical Properties

Shrinkage Stress
Cusp Deflection
Shrinkage can cause stress in the tooth, the bonding layer and within the composite. Stress can be a result of the
combination of shrinkage and modulus. For materials with similar shrinkage, the material with the higher modulus (or
stiffness) will produce greater stress. Conversely, for materials with similar modulii, the material that exhibits the highest
shrinkage will produce greater stress. Cusp deflection is a 3M test method that was designed to provide a relative
estimate of polymerization shrinkage stress resulting from placing and curing a dental composite in a 4x4 mm
open-ended cavity. The cavity dimension roughly simulates a large cavity preparation (e.g., mesial – occlusal – distal
(MOD) preparation). The surface of the aluminum cavity is sandblasted, silane treated and a dental adhesive is applied.
A composite is then placed in the aluminum cavity to a final depth of 4 mm, either incrementally or bulk filled, and
cured with a dental curing light (e.g., one 4 mm deep application of bulk fill composite or two 2 mm deep increments of
incremental composite, each placed and light cured). A linear variable displacement transducer is used to measure the
displacement of the aluminum cavity wall due to polymerization shrinkage stress. Aluminum was selected as the block
material because it has a modulus similar to human enamel. A similar cusp deflection method using an aluminum block
has been described in the literature.4

Figure 10: Cusp Deflection of 14

common bulk fill
and incrementally
placed composites
12
Source: 3M internal data
Cusp Deflection (microns)

10

0
Filtek™ HyperFIL™ QuiXX® SureFil™ X-tra fil SonicFill™ Grandio® Herculite® TPH Filtek™
Bulk Fill Posterior Posterior SO Ultra Spectra™ Z250
Posterior Restorative Restorative HV Universal
Restorative

16
14
Park J, Chang J, Ferracane J, Lee IB: How should composite be layered to reduce shrinkage stress: Incremental or bulk filling? Dental Materials 2008; 24:501-1505.
4
12
ral Modulus (Gpa)

10
12
8
6
 Cusp Deflection (microns)
10
14
8 Physical Properties
12
6
Cusp Deflection (microns)

10
4

Flexural
2
8
Modulus
6
Flexural modulus is a method of defining a material’s stiffness. A high modulus indicates a rigid material. The flexural
0
modulus is measured by applying a load to a material specimen that is supported at each end. A low flexural™ modulus
4 Filtek HyperFIL™ QuiXX® SureFil™ X-tra fil SonicFill™ Grandio® Herculite® TPH Filtek
™

can aid in reducing

Bulk Fill stress generated duringPosterior
Posterior cure. SO Ultra Spectra™ Z250
Posterior Restorative Restorative HV Universal
2 Restorative

0
Filtek™ HyperFIL™ QuiXX® SureFil™ X-tra fil SonicFill™ Grandio® Herculite® TPH Filtek™
16 Bulk Fill Posterior Posterior SO Ultra Spectra™ Z250 Figure 11: Flexural modulus of
Posterior Restorative Restorative HV Universal common bulk fill
14 Restorative composites
12
Flexural Modulus (Gpa)

Source: 3M internal data

10
816
614
412
Flexural Modulus (Gpa)

210
08
6 Filtek™ Bulk Tetric EvoCeram® HyperFIL™ SonicFill™ QuiXX® Posterior X-tra fil
Fill Posterior Bulk Fill Restorative
4
2
0
16 Filtek™ Bulk Tetric
70EvoCeram® HyperFIL™ SonicFill™ QuiXX® Posterior X-tra fil
14 Fill Posterior Bulk Fill Restorative
60
Polish Retention (gloss %)

12
Flexural Modulus (Gpa)

50
10
816 40
Figure 12: Flexural modulus
614 30 of common
incrementally
412 placed
Flexural Modulus (Gpa)

20 composites
210 Source: 3M internal data
10
08
0
Filtek™ Bulk Tetric EvoCeram® Herculite® Ultra TPH Spectra™ Filtek™ Supreme Grandio® SO
6 Fill Posterior HV® SO Ultra Universal
Filtek™ Bulk Fill Grandio Tetric EvoCeram®
TPH Spectra™ HV Herculite® Ultra
4 Posterior Bulk Fill

2
0
2.5
Filtek™ Bulk Tetric EvoCeram® Herculite® Ultra TPH Spectra™ Filtek™ Supreme Grandio® SO
Fill Posterior HV Ultra Universal

2 2.5
Wear (relative to Z250)

1.5
2.5 2
ss (MN m-3/2)

13
12
1.5
0)
 0
Filtek™ Bulk Tetric EvoCeram® HyperFIL™ SonicFill™ QuiXX® Posterior X-tra fil
Fill Posterior Bulk Fill Restorative
Physical Properties

16
In-vitro,
14 3-Body Wear
12
Flexural Modulus (Gpa)
The wear rate was determined using an in-vitro 3-body wear test. In this test, composite (1st body) is loaded onto a
10 which contacts another wheel, which acts as an “antagonistic cusp” (2nd body). The two wheels counterrotate
wheel,
against
8 one another dragging abrasive slurry (3rd body) between them. Dimensional loss is determined by profilometry
at the6 end of 200,000 cycles. In tests where wear is monitored at regular intervals, it is found to be linear. Consequently,
wear rates can be predictive beyond the length of the actual test.
4
The 3-body
2 wear of Filtek™ Bulk Fill Posterior Restorative is significantly less than a number of bulk fill and
incrementally placed composites, including SonicFill and Tetric EvoCeram Bulk Fill (Figure 13).
0
Filtek™ Bulk Tetric EvoCeram® Herculite® Ultra TPH Spectra™ Filtek™ Supreme Grandio® SO
Fill Posterior HV Ultra Universal

2.5
Figure 13: 3 -body wear
of common
bulk fill and
incrementally
2
placed
3-Body Wear (relative to Z250)

composites
Source: Oregon Health & 1.5
Science University

14 0.5

12
0
Cusp Deflection (microns)

10 Filtek™ Bulk SonicFill® QuiXX® HyperFIL™ Tetric TPH Tetric Herculite® Filtek™ Z250
Fill Posterior Posterior EvoCeram® Spectra™ EvoCeram® Ultra Universal
Restorative Bulk Fill HV Restorative
8

6
Polish Retention
4 70
Toothbrush Abrasion
2 Composite materials were shaped into tiles and thoroughly cured. The surfaces were polished wet using a Buehler
60
variable-speed grinder-polisher to remove the air-inhibited layer and to ensure a uniform surface. They were stored in
0
water at 37ºC for 24 hours. Gloss was measured. The samples were brushed with toothpaste and a toothbrush that was
Filtek™ HyperFIL™ 50QuiXX® SureFil™ X-tra fil SonicFill™ Grandio® Herculite® TPH Filtek™
Polish Retention (gloss %)

Bulk Fillmounted on an AutomaticPosterior

Posterior Toothbrush Machine. Gloss measurements
SO UltrawereSpectra
taken ™after Z250
500 cycles and then every 1000
Posteriorcycles. The test
Restorative Restorative
was terminated after 6000 toothbrush strokes. HV Universal
40 Restorative
The polish retention of Filtek Bulk Fill Posterior Restorative is significantly higher than a number of bulk fill composites,
including SonicFill and Tetric EvoCeram Bulk Fill (Figure 14), and significantly higher than a number of incrementally
30
16 placed composites, including Herculite Ultra and TPH Spectra HV (Figure 15).

14 20
12
dulus (Gpa)

14
10 10
 0

Fractur
Filtek™ Bulk SonicFill® QuiXX® HyperFIL™ Tetric TPH Tetric Herculite® Filtek™ Z250
Fill Posterior 0.5 Posterior EvoCeram® Spectra™ EvoCeram® Ultra Universal
Restorative Bulk Fill HV Restorative
Physical Properties
0
Filtek™ Bulk Fill Tetric EvoCeram® QuiXX® X-tra Fil HyperFIL™ SonicFill™
Posterior Bulk Fill Posterior
70 Restorative

60 Figure 14: Polish retention of

common bulk fill
composites
50 3
Polish Retention (gloss %)

Source: 3M internal data

2.5
40
Fracture Toughness (MN m-3/2)

2
30

1.5
20

1
10

0.5
0
Filtek™ Bulk 0SonicFill
®
Alert® X-tra fil Tetric QuiXX® Surefil™
Fill Posterior EvoCeram® Posterior Posterior
Filtek™ Tetric Herculite® Filtek
Bulk™Fill Grandio
Restorative
®
TPHRestorative
Filtek™ Z250 Filtek™ P60
Bulk Fill EvoCeram® Ultra Supreme SO Spectra™ Universal Posterior
Posterior Ultra HV Restorative Restorative
Universal

180

160

70 140
Figure 15: Polish retention
60 of common
120
Flexural Strength (MPa)
Polish Retention (gloss %)

incrementally
50 placed composites
100
Source: 3M internal data
40
80
30
60
20

10 40

0 20
Filtek Bulk Fill
™
Grandio® SO Tetric EvoCeram® TPH Spectra™ HV Herculite® Ultra
Posterior 0 Bulk Fill
Filtek™ Tetric QuiXX® HyperFIL™ X-tra Fil SonicFill™
Bulk Fill EvoCeram® Posterior
Posterior Bulk Fill Restorative

2.5 200

180
2 160 15
m-3/2)

140
Pa)
 60 4

Polish Retention (gloss %)

Flex
4

Fl
60

Polish Retention (gloss %)

2 50
2
50
0 40
0
Physical Properties
Filtek ™
Bulk 40
Tetric EvoCeram ®
Herculite® Ultra TPH Spectra™™ Filtek™™ Supreme Grandio® SO
Filtek ™
Bulk
Fill Posterior Tetric EvoCeram
30
®
Herculite® Ultra TPH Spectra
HV Filtek
Ultra Supreme
Universal Grandio® SO
Fill Posterior 30 HV Ultra Universal
20
20
10
2.5
2.5
10
0 Fracture Toughness
0
The values reported
Filtekfor
™
fracture
Bulk Fill toughness
Grandio(K1c)
®
SO are related
TetrictoEvoCeram
the energy®
required to propagate
TPH Spectra ™
HV aHerculite
crack. In® Ultra
this test, a
Filtek Bulk
Posterior
™
Fill Grandio ®
SO Tetric
BulkEvoCeram
Fill ®
TPH Spectra ™
HV Herculite®
Ultra
2 short bar of materialPosterior
is cured. A notch is cut into it. The bar is Bulk
placed
Fill on a fixture that supports either end and an anvil is
2
positioned above the notch. The anvil presses down until the bar breaks.
3-Body Wear (relative to Z250)
3-Body Wear (relative to Z250)

1.5 The fracture toughness of Filtek™ Bulk Fill Posterior Restorative is higher than Tetric EvoCeram Bulk Fill and QuiXX
1.5
Posterior Restorative (Figure 16).
1
1
Figure 16: Fracture 2.5
toughness of 2.5
common bulk fill
composites
0.5
0.5 2
Source: 3M internal data
2
Fracture Toughness (MN m-3/2)
Fracture Toughness (MN m-3/2)

0
0
Filtek ™
Bulk 1.5
SonicFill
1.5 ®
®
QuiXX ®
HyperFIL ™
Tetric TPH Tetric Herculite®® Filtek™™ Z250
Filtek ™
Bulk SonicFill
Fill Posterior QuiXX
Posterior HyperFIL
® ™
EvoCeram Tetric ® Herculite
TPH ™ EvoCeram
Tetric ® Spectra Ultra Filtek Z250
Universal
Fill Posterior Posterior
Restorative EvoCeram ®
HV EvoCeram
Bulk Fill Spectra
™ ®
Ultra Universal
Restorative
Restorative Bulk Fill HV Restorative
1
1

70 0.50.5
70

60 00
60
Filtek
Filtek™Bulk
™
BulkFillFill Tetric
TetricEvoCeram
EvoCeram®
®
QuiXX ®
QuiXX® X-tra
X-traFilFil HyperFIL™
HyperFIL™ SonicFill™
SonicFill™
Posterior
Posterior Bulk Fill
Bulk Fill Posterior
Posterior
50 Restorative
Polish Retention (gloss %)

50 Restorative
Polish Retention (gloss %)

The fracture toughness of Filtek Bulk Fill Posterior Restorative is higher than Tetric EvoCeram and
40
40 Herculite Ultra (Figure 17).
Figure 17:  Fracture
30
toughness 33
30
of common
incrementally
placed
20 2.52.5
20
composites
Fracture Toughness (MN m-3/2)
Fracture Toughness (MN m-3/2)

Source: 3M internal data

10 22
10

0 1.51.5
0
Filtek™ Bulk SonicFill® Alert® X-tra fil Tetric QuiXX® Surefil™
Filtek ™
Bulk
Fill Posterior SonicFill
11
®
Alert® X-tra fil Tetric ®
EvoCeram QuiXX ®
Posterior Surefil™
Posterior
Fill Posterior EvoCeram
Bulk Fill® Posterior
Restorative Posterior
Restorative
Bulk Fill Restorative Restorative
0.50.5

00
Filtek
Filtek™™
Tetric
Tetric Herculite
Herculite ®®
Filtek™™
Filtek Grandio®®
Grandio TPH Filtek™™Z250
TPH Filtek Z250 Filtek™™ P60
Filtek P60
BulkFillFill EvoCeram
Bulk EvoCeram ®®
Ultra
Ultra Supreme
Supreme SO
SO Spectra™™ Universal
Spectra Universal Posterior
Posterior
Posterior
Posterior Ultra
Ultra HV
HV Restorative
Restorative Restorative
Restorative
Universal
Universal
16
 2.5

(MNmm-3/2 )
-3/2)
2
2
Toughness(MN
FractureToughness Physical Properties
1.5
1.5

1
Fracture

Flexural
0.5
0.5
Strength and Compressive Strength
Flexural strength is determined in the same test as flexural modulus. Flexural strength is the value obtained when the
sample0
0 breaks. This test combines the forces found in compression and tension. Compressive strength is particularly
important because Tetric
Filtek™™ of chewing Herculite®
Filtek™ TPH Filtekforces
Grandio®® and simultaneous ™
Z250 Filtek ™
P60
Filtek Tetric forces.
Bulk Fill EvoCeram ®
Rods®are made
Herculite
Ultra Filtek™of the Grandio
Supreme
material
SO TPH ™ Filtek
Spectra
™
Z250are
Universal
applied
Filtek™
P60to the
Posterior
Bulk
opposite ends Fill EvoCeram Ultra Supreme
of the sample length. The sample failure
Posterior
®
SO Spectra
Ultra is a result of shear and Universal
HV tensile
™
Posterior
forces. Restorative
Restorative
Posterior Ultra
Universal HV Restorative Restorative
Universal
The flexural strength of Filtek™ Bulk Fill Posterior Restorative is higher than Tetric EvoCeram Bulk Fill and QuiXX Posterior
Restorative and similar to other common bulk fill composites (Figure 18).

180
180
Figure 18: Flexural strength
160 of common bulk
160 fill composites
140 Source: 3M internal data
140
120
(MPa)

120
Strength(MPa)

100
FlexuralStrength

100
80
80
Flexural

60
60
40
40
20
20
0
0
Filtek™™ Tetric QuiXX® HyperFIL™ X-tra Fil SonicFill™
Filtek
Bulk Fill Tetric ®
EvoCeram QuiXX®
Posterior HyperFIL™ X-tra Fil SonicFill™
Bulk Fill
Posterior EvoCeram
Bulk Fill
®
Posterior
Restorative
Posterior Bulk Fill Restorative
The flexural strength of Filtek Bulk Fill Posterior Restorative is higher than Tetric EvoCeram and Herculite Ultra and similar
to other common incrementally placed composites (Figure 19).
200
200
180
180 Figure 19: Flexural strength
of common
160
160 incrementally
placed
140
(MPa)

140 composites
(MPa)

120
Strength

120 Source: 3M internal data

Strength

100
100
80
Flexural

80
Flexural

60
60
40
40
20
20
0
0
Filtek™ Bulk Fill Tetric Herculite® TPH Spectra™ Filtek™ Gradio® SO
FiltekPosterior
™
Bulk Fill Tetric ®
EvoCeram Herculite® TPH Spectra
HV ™ Filtek™Ultra
Supreme Gradio® SO
Posterior EvoCeram® HV Supreme Ultra
Universal 17
Universal
 Physical Properties

400
Figure 20: Compressive
strength of
common bulk fill 350
composites
Source: 3M internal data 300
Compressive Strength (MPa)

250

200

150

100

50

0
Filtek™ Bulk Fill QuiXX® SonicFill™ HyperFIL™ Tetric EvoCeram® X-tra Fil
Posterior Posterior Bulk Fill
Restorative

18
 Questions and Answers

Questions and Answers

What makes Filtek™ Bulk Fill Posterior Restorative unique?

The AFM monomer used in Filtek Bulk Fill Posterior Restorative allows dentists to place one-step restorations
without compromising wear resistance or stress relief. This, in addition to its excellent handling, makes
Filtek Bulk Fill Posterior Restorative a truly a unique restorative material.

What is the benefit of Filtek Bulk Fill Posterior Restorative vs. incrementally placed composites?

The greatest benefit is fast and easy one-step placement. You can restore a 5 mm deep Class II preparation significantly
faster than placing and curing in increments.

How is Filtek Bulk Fill Posterior Restorative different than Filtek™ Bulk Fill Flowable Restorative?

The greatest difference is Filtek Bulk Fill Posterior Restorative has been designed as a stress-bearing restoration with
strength properties similar to other universal and posterior composite restoratives. It can also be filled to the occlusal
surface up to 5 mm. On the other hand, when Filtek Bulk Fill Flowable Restorative is used in a stress-bearing Class I or
II restoration, a 2 mm minimum thickness of a traditional composite must be used on the occlusal surface.

What is the volumetric shrinkage of Filtek Bulk Fill Posterior Restorative?

The shrinkage of Filtek Bulk Fill Posterior Restorative is similar to Filtek™ Z250 and Filtek™ Supreme Ultra
Universal Restoratives.

What’s the difference between polymerization shrinkage and polymerization stress?

Polymerization shrinkage, when expressed as a volume, is simply the decrease in volume of the composite as it shrinks
due to the curing process. Polymerization shrinkage stress is the stress created 1) in the bonding interface between the
tooth and the shrinking composite, 2) in the tooth provided the adhesive does not fail, and 3) in the composite between
the shrinking resin and the filler particles.

19
Questions and Answers

Why is polymerization shrinkage stress important?

Polymerization shrinkage stress can contribute to adhesive failure between the tooth and composite, which may result
in post-operative sensitivity, marginal leakage and marginal discoloration. If the bond does not fail, polymerization
stress may cause fracture of the enamel adjacent to the cavosurface, which may contribute to marginal ditching
over time. Polymerization stress may also cause an inward deflection of the cusps in Class II restorations. Over time,
composites have been observed to absorb sufficient water to compensate for some or most of this deflection.10

How do the new monomers help relieve polymerization stress?

Filtek™ Bulk Fill Posterior Restorative contains two novel methacrylate monomers that, in combination, act to lower
polymerization stress. One monomer, a high molecular weight aromatic dimethacrylate (AUDMA) decreases the
number of reactive groups in the resin. This helps to moderate the volumetric shrinkage as well as the stiffness of the
developing and final polymer matrix—both of which contribute to the development of polymerization stress.

The second unique methacrylate represents a class of compounds called addition-fragmentation monomers (AFM).
During polymerization, AFM reacts into the developing polymer as with any methacrylate, including the formation
of cross-links between adjacent polymer chains. AFM contains a third reactive site that may cleave through a
fragmentation process during polymerization. This process provides a mechanism for the relaxation of the developing
network and subsequent stress relief. The fragments, however, still retain the capability to react with each other or with
other reactive sites of the developing polymer. In this manner, stress relief is possible while maintaining the physical
properties of the polymer.

Is this a nano-filled material? What is the filler?

The filler system uses the same nanofiller technology as Filtek Supreme Ultra restoratives–a combination of
silane-treated nanoclusters and individual silane-treated nanosilica and nanozirconia. In addition, it contains nano-scale
ytterbium trifluoride to impart improved radiopacity.

How does the radiopacity compare to our other composites?

Filtek Bulk Fill Posterior Restorative is one of our most radiopaque composites. We achieve this high level of radiopacity
by incorporating nano ytterbium trifluoride.

20
 Questions and Answers

Why is Filtek™ Bulk Fill Posterior Restorative described as a BPA-free dental material?

We’ve replaced the BisGMA monomer that is used in our other composites with a dimethacrylate that does not use
Bisphenol A in its synthesis. This was done to maximize the stress relief during polymerization.

What adhesive should I use with Filtek Bulk Fill Posterior restorative?

All methacrylate-based dental adhesives are compatible with Filtek Bulk Fill Posterior Restorative.

How can I be assured of getting good cavity adaptation of Filtek Bulk Fill Posterior Restorative—
especially in the proximal box?

Start dispensing in the deepest portion of the preparation, holding the tip close to the preparation surface. For proximal
areas, hold the tip against the matrix to aid material flow into the proximal box. Withdraw the capsule tip slowly as the
cavity is filled, and avoid lifting the tip out of dispensed material while dispensing to reduce voids. When dispensing has
been completed, drag the capsule tip against the cavity wall while withdrawing from the operative field.

What is the curing protocol?

It depends upon the class of restoration and the intensity of your curing lamp. For Class II restorations that are 5 mm
deep, we instruct curing for 10 sec from the occlusal surface followed by curing 10 sec each from the mesio- and/or
distobuccal and lingual directions after having removed the matrix band. For a Class I restoration, which is not likely
to be more than 4 mm deep, we instruct curing from the occlusal surface for 20 sec. These times are applicable for
curing lamps with an intensity of 1000mWcm-2 or greater. For curing lamps with intensities less than 1000mWcm-2,
we instruct that the cure times are doubled.

All halogen lights 3M™ ESPE™ LED

Caries Increment
(with output of lights (with output
Classification Depth
550-1000mW/cm2) 1000-2000mW/cm2)
Classes I, III, IV and V 4 mm 40 sec 20 sec
20 sec occlusal, 10 sec occlusal,
Class II 5 mm 20 sec buccal, 10 sec buccal,
20 sec lingual 10 sec lingual
Note: For class II restorations, remove the matrix band prior to the buccal and lingual curing steps.

21
Questions and Answers

Yes, but how can I be sure that I’m getting a sufficient cure at 5 mm?

The three-sited curing technique that we recommend was based on in vitro studies carried out at the Oregon Health
& Science University. We discovered in a 5 mm-deep Class II preparation that the cure adjacent to the metal matrix
band was equivalent to the cure down the center of the restoration as well as the cure at the restoration-tooth interface
when a three-sited curing technique was used. When the restoration was cured from the occlusal direction only, the
cure adjacent to the metal matrix tended to be lower at deeper depths compared to the rest of the restoration. This
tells us that there is less light available for polymerization adjacent to metal matrix bands at deeper depths within the
restoration. A three-sited curing technique overcomes that limitation.

Does a 4 mm Class II restoration require the three-sited curing technique or can I cure it for 20 seconds
as you described for a Class I?

To ensure sufficient cure throughout the restoration, we recommend the three-sited curing technique be used for 4 mm
Class II restorations as well.

What are the indications for use?

Filtek™ Bulk Fill Posterior Restorative was designed to be durable in stress-bearing Class I and II restorations. The bulk fill
capability also makes it appealing as a light-cured core build-up. In the Instructions for Use, it is noted that
Filtek Bulk Fill Posterior Restorative can be used in Class III through V restorations. As Filtek Bulk Fill Posterior
Restorative is semi-translucent, the esthetic outcome in anterior restorations will be affected by variables such as the
location of the restoration and underlying tooth color. When esthetics are a primary outcome, we recommend using a
Filtek™-branded universal restorative. See Instructions for Use for a complete list of indications.

What shades are offered and how do they compare to our other Filtek products?

There are five shades of Filtek Bulk Fill Posterior Restorative: A1, A2, and A3, B1 and C2. These are based on the
Vitapan Classical Shade Guide, and hence are similar to the Filtek Supreme family of composites. Filtek Bulk Fill
Posterior Restorative shades, however, are more translucent than all but the translucent shades of Filtek™ Supreme
family to enable the bulk curing feature.

22
 References

References

[1] Opdam N, Roeters F, Peters M, Burgersdijk R, Teunis M. Cavity wall adaptation and voids in adhesive
Class I restorations. Dent Mater 1996; 12:230–235.

[2] Opdam N, Roeters F, Joosten M, Veeke O. Porosities and voids in Class I restorations by six operators
using a packable or syringable composite. Dent Mater 2002; 18:58–63.

[3] Herrero A, Yaman P, Dennison J. Polymerization shrinkage and depth of cure of packable composites.
Quintessence Int 2005; 36:35 –31.

[4] Halvorson R, Erickson R, Davidson C. An energy conversion relationship predictive of conversion profiles and
depth of cure of resin-based composite. Oper Dent 2003; 28:307-314.

[5] Ferracane J. Correlation between hardness and degree of conversion during the setting reaction of unfilled dental
restorative resins. Dent Materials 1985; 1:11-14.

[6] Bouschlicher M, Rueggeberg F, Wilson B. Correlation of bottom-to-top surface microhardness and conversion
ratios for a variety of resin composite compositions. Oper Dent 2004; 29:698-704.

[7] You C, Xu X, Burgess JO. Depth of cure of core-build material with three different curing lights [abstract 1736].
J Dent Res 2001; 80:252.

[8] Ernst CP, Meyer GR, Müller J, Stender E, Ahlers MO, Willershausern B. Depth of cure of LED vs QTH light-curing
devices at a distance of 7 mm. J Adhes Dent. 2004; 6(2):141-50.

[9] Vandevalle K, Ferracane J, Hilton T, Erickson R, Sakaguchi R. Effect of energy density on properties and marginal
integrity of posterior resin composite restorations. Dent Materials 2004; 20:96-106.

[10] Campodonico C, Tantbirojn D, Olin P, Versluis A. Cuspal deflection and depth of cure in resin-based composite
restorations filled by using bulk, incremental and transtooth-illumination techniques. J Am Dent Assoc 2011;
142:1176-1182.

23
 www.3M.com/dental
Oral Care 3M, ESPE, Elipar, Filtek, Scotchbond,
Soft-Lex and Vitrebond are trademarks of
3M or 3M Deutschland GmbH. Used under
Dental Products 3M Canada license in Canada. © 3M 2015.
2510 Conway Avenue
Post Office Box 5757 All rights reserved. Alert, Grandio SO,
St. Paul, MN 55144-10000 USA
London, Ontario N6A 4T1 Herculite, HyperFIL, QuiXX, SonicFill, SureFil,
1-800-634-2249
Canada Please recycle. Printed in U.S.A. Tetric Evo Ceram, TPH, Spectra, VITAPAN
1-888-363-3685 70-2013-0659-7 and X-tra fil are not trademarks of 3M.