SDR: 15 Years of Excellent Bulk Fill Technology

In 2009, the launch of SDR (Smart Dentin Replacement) bulk-fill composite revolutionized restorative dentistry. It became the most preferred flowable material for use as a base liner in 4 mm placements, offering a flowable consistency. With more than 135 million applications¹ and several long-term clinical studies, SDR flow+ remains the bulk-fill technology of choice for quick and easy direct restorations, providing clinically reliable results.²

Bulk-fill composites were developed in the late 1990s. These composites consisted of a higher proportion of filler and demonstrated less volume shrinkage than universal composites, whose polymerization stress often caused marginal gaps and led to clinical failures when placed in larger increments. The first bulk-fill composites had to be packed into the cavity to ensure proper adaptation. Since 2009, flowable bulk-fill composites have been available, with their polymerization stress comprehensively analyzed.³ Tests showed that the special flowable bulk-fill chemistry in SDR flow+⁴ from Dentsply Sirona had lower shrinkage stress. This unique property makes SDR flow+ an excellent bulk-fill material and the gold standard for posterior cavities to this day. It is one of the most commonly used self-leveling bulk-fill composites for underfillings in Class I and II restorations.

Seamless Adaptation for More Efficiency in Dental Procedures

The flowable composite enables gap-free restorations, even in hard-to-reach areas, and is indicated for various dental procedures, including filling Class I, II, III, and V cavities, sealing pits and fissures, and even core build-ups before crown placement. Because SDR flow+ can be applied in one step to a depth of up to 4 mm, restorations can be completed in less time and with fewer steps. Additionally, the adaptable, self-leveling bulk-fill composite flows—even against gravity—into all recesses of the cavity, ensuring seamless adaptation. Manipulation with an instrument is not necessary. Excellent clinical results can be reliably achieved by reducing the risk of marginal gaps and secondary caries. Another advantage of SDR flow+ is its radiopacity, which simplifies long-term monitoring of the restoration.

Dr. Alan Atlas, a dentist specializing in restorative dentistry from Philadelphia, USA, has been using Dentsply Sirona’s bulk-fill composite for many years. He states, “After 15 years, SDR flow+ remains the most effective composite ever developed⁵ for dentin replacement in direct restorations. Its ability to seal dentin margins is especially crucial in Class II posterior composites, significantly reducing the risk of recurrent decay and postoperative sensitivity. It has truly been a game-changer in restorative dentistry.”

Benefits for Both Dentist and Patient

SDR flow+ can also increase the productivity of dental practices. Direct restorations account for about one-third of the annual turnover of a general dental practice. Ugurlu et al. concluded in a retrospective study⁶ that SDR flow+ can reduce the time required for posterior fillings compared to conventional composites and extended layering techniques. This, in turn, has the potential to improve the cost-effectiveness of the practice. SDR flowable bulk-fill technology also eliminates the need for an additional liner before application, which reduces practice inventory.

Patients benefit from shorter treatment times, especially children and those who have difficulty tolerating prolonged dental procedures. SDR flow+ also has a low risk of post-operative sensitivity.⁷ Additionally, the clinical longevity of the restoration is comparable to that achieved using small increments in conventional techniques.⁸ Besides the universal shade, SDR flow+ is available in three additional shades (A1, A2, and A3), increasing its versatility for a wide range of cases, including visible Class II restorations, primary posterior dentition, and Class III and Class V restorations.

“With the development of SDR and SDR flow+, Dentsply Sirona has created a true game-changer in restorative therapy,” explains Julie Mroziak, vice president of restorative solutions at Dentsply Sirona. “Today, it is one of the most extensively studied dental restoration materials and has achieved excellent clinical results in over 135 million restorations. In vitro and clinical studies prove that dentists can proceed with confidence by using SDR flow+ as a bulk-fill flowable, a high-quality material because of its adaptation and efficiency for direct restorations.”

Click here to learn more (SDR flow+ | Bulk Fill Flowable | Dentsply Sirona USA).

About Dentsply Sirona

Dentsply Sirona is the world’s largest manufacturer of professional dental products and technologies, with over a century of innovation and service to the dental industry and patients worldwide. Dentsply Sirona develops, manufactures, and markets a comprehensive solutions offering including dental and oral health products as well as other consumable medical devices under a strong portfolio of world class brands.

Dentsply Sirona’s products provide innovative, high-quality and effective solutions to advance patient care and deliver better and safer dental care.

Dentsply Sirona’s headquarter is located in Charlotte, North Carolina. The company’s shares are listed in the United States on NASDAQ under the symbol XRAY.

Visit www.dentsplysirona.com for more information about Dentsply Sirona and its products.

REFERENCES

1. Based on Dentsply Sirona sales reporting 2009 – Feb. 2024. Internal data on file. For more information, contact [email protected]

2. Collection of Studies & Cases: https://www.dentsplysirona.com/content/dam/flagship/de-de/explore/restauration/DS_DE_SDR_Flow_Plus_Bulk_Fill_Flowable.pdf

3. Kaisarly D, Langenegger R, Litzenburger F, Heck K, El Gezawi M, Rösch P, Kunzelmann KH. Effects of application method on shrinkage vectors and volumetric shrinkage of bulk-fill composites in class-II restorations. Dent Mater. 2022 Jan;38(1):79-93.

4. Marketed as SDR flow+ Bulk Fill Flowable or SDR Plus Bulk Fill Flowable based on location.

5. Regarding number of scientific publications, number of applications sold worldwide, market share in bulk fill composite segment and the combination of easy application and long-term survival rates in 6-year controlled clinical studies.

6. Ugurlu M, Sari F. A 3-year retrospective study of clinical durability of bulk-filled resin composite restorations. Restor Dent En-dod. 2021 Dec 30;47(1):e5.

7. Collection of Studies & Cases: https://www.dentsplysirona.com/content/dam/flagship/de-de/explore/restauration/DS_DE_SDR_Flow_Plus_Bulk_Fill_Flowable.pdf

8. Kaisarly D, Langenegger R, Litzenburger F, Heck K, El Gezawi M, Rösch P, Kunzelmann KH. Effects of application method on shrinkage vectors and volumetric shrinkage of bulk-fill composites in class-II restorations. Dent Mater. 2022 Jan;38(1):79-93.

DISCLAIMER

This information and any attachment thereto contains “forward-looking statements” within the meaning of the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Such statements are not guarantees of future performance. These forward-looking statements reflect views and assumptions regarding expectations and projections about future events and are based on currently available information or information available on the date of any document incorporated by reference. You can generally identify these forward-looking statements by the use of words such as “may,” “could,” “estimate,” “will,” “believe,” “anticipate,” “think,” “intend,” “expect,” “project,” “plan,” “target,” “forecast”, and similar words and expressions. However, these words are not the exclusive means of identifying such statements.

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Readers are cautioned not to place undue reliance on such statements, which speak only as of the date hereof. Except as required by law, the Company does not assume any obligation to update any forward-looking statements contained in this document or the attachments to reflect new information or future events or developments after the date any such statement is made.

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