This systematic review evaluates the marginal integrity of flowable and packable bulk fill composite materials placed in class II cavities. Electronic databases inclusive of MEDLINE, Scopus, and Web of Science were searched without restriction to date. The titles and abstracts of publications gathered from database searches were screened by reviewers according to the inclusion and exclusion criteria. From as initial yield of 142 articles ten studies were subject to qualitative analysis. The authors emphasized that marginal integrity in enamel and dentin does not significantly differ between flowable and packable bulk fill composites used for class II restorations. Moreover, their marginal integrity was comparable to conventional resin composites with incremental techniques. The adhesive system used with a total etch technique and assessed margin located in enamel resulted in better marginal integrity.

Contrary to the drive to simplify bonding technologies, an appreciation of their adhesive components and how these perform according to bonding technique could yield a knowledge-based practical approach that ultimately improves the longevity of direct composite restorations.