Clinical effectiveness of bulk-fill composite resins in restorative dentistry: a scoping review and thematic analysis

OBJECTIVES: To map the clinical evidence regarding the applications, advantages, and limitations of bulk-fill composite resins in restorative dentistry. DATA: The study protocol was registered on the Open Science Framework platform (doi: 10.17605/OSF.IO/VG92D). This scoping review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. SOURCES: Comprehensive searches were performed in Medline (PubMed), ProQuest (Dissertations & Theses), SciELO, Scopus, Virtual Health Library (VHL), and Web of Science (WoS). The search was initially conducted in February 2025 and updated in November 2025. Study selection was performed by two reviewers independently. STUDY SELECTION: A total of 1,837 records were identified (1,806 from the initial search and 31 from the update). Full-text analysis was conducted for 80 studies from the initial search. Ultimately, 65 studies were definitively included in the review (58 from the initial search and 7 from the update), consisting of a descriptive synthesis and a thematic analysis. CONCLUSIONS: Clinical evidence supports bulk-fill resins as a resource-efficient alternative to incremental layering with comparable survival rates. Although they simplify procedures, longevity relies on the adhesive strategy and technical execution rather than material chemistry. Future standardized trials are required to minimize the data heterogeneity observed in the current literature. CLINICAL SIGNIFICANCE: Bulk-fill composite resins are predictable and effective materials for direct restorations, providing a simplified and reliable alternative to the traditional incremental layering technique.