Postoperative sensitivity associated with low shrinkage versus conventional composites

Abstract

Postoperative sensitivity in restorative dentistry can be related to preparation trauma, dentin adhesives' ability to seal open dentinal tubules, deformation of restorations under occlusal stresses and microleakage. The study assessed possible reduction in postoperative sensitivity with low shrinkage compared to conventional composites using different bonding agents and the influence of the operator skill on the incidence of postoperative sensitivity. Nine hundred and sixty permanent premolars and molars with primary carious lesions from patients 21 to 40 years old were used. Cavities 2 to 3 mm deep and with margins in enamel were prepared by four operators. Two operators had five years (A and B) and two had over 20 years (C and D) of clinical experience. Teeth were divided into eight groups each contained 120 restorations: (1) Els+James-2 (original formula), (2) Els+James-2 (new formula), (3) Els+Excite, (4) InTenSe+James-2 (original formula), (5) InTenSe+James-2 (new formula), (6) InTenSe+Excite, (7) Tetric Ceram+Excite, and (8) Point 4+OptiBond Solo Plus. At 14 days postoperatively, two independent operators, who did not take part in the clinical procedure, assessed postoperative teeth sensitivity using special questionnaires. Data were analyzed using non-parametric chi-square, Mann-Whitney and ANOVA tests. Group 8 showed significantly higher score than the other groups. Less postoperative sensitivity was reported with two low-shrinkage composites (groups 2, 3, and 5) but with no significant difference. There was no statistical difference between groups 1, 2, 3, 4, 5, 6 and 7. Operator A had the highest postoperative sensitivity score compared to the other three. Conventional composite material Point 4 with its bonding agent caused significantly more postoperative sensitivity than low shrinkage composites combined with different adhesives. Operator skill influenced the incidence of postoperative sensitivity.