Influence of Adhesive Type and Placement Technique on Postoperative Sensitivity in Posterior Composite Restorations

Abstract

SUMMARY Purpose: This double blind, randomized clinical trial compared the postoperative sensitivity of the placement technique (incremental and bulk fill) in posterior composite resin restorations bonded with two different adhesive strategies (self-etch and etch-and-rinse). Methods: Posterior dental cavities of 72 participants (n=236), with a cavity depth of at least 3 mm, were randomly divided into four groups. The restorations were bonded using either the etch-and-rinse Tetric N-Bond (Ivoclar Vivadent) or the self-etch Tetric N-Bond SE (Ivoclar Vivadent). The composite resin Tetric N-Ceram Bulk Fill (Ivoclar Vivadent) was placed either incrementally or using the bulk-fill technique. Two experienced and calibrated examiners evaluated the restorations using World Dental Federation criteria after one week of clinical service. Spontaneous postoperative sensitivity was assessed using a 0-4 numerical rating scale and a 0-10 and 0-100 visual analog scale up to 48 h after the restorative procedure and after one week. Results: The risk (p>0.49) and intensity of spontaneous postoperative sensitivity (p>0.38) was not affected by the adhesive strategy or the filling technique. The overall risk of postoperative sensitivity was 20.3% (95% confidence interval 15.7-25.9) and typically occurred within 48 hours after the restorative procedure. Conclusions: The overall risk of immediate postoperative sensitivity was 20.3% and was not affected by either the adhesive strategy (etch-and-rinse/self-etch) or the filling technique (incremental/ bulk).