Occurrence and Causing Stimuli of Postoperative Sensitivity in Composite Restorations

Abstract

SUMMARYDespite improvements in composite treatments over the past decade, postoperative sensitivity still remains a problem. Therefore, this clinical study evaluated the appearance of postoperative sensitivity after composite treatments and the stimuli that may have caused it. A total of 600 teeth in 231 patients was included in this study. All treatments were performed by dental students working under close supervision following standard procedures and using the bonding system Optibond FL and the nanofilled composite Ceram X. At baseline (visit 1), the restorations were grouped according to the following criteria: use of anesthesia, use of a rubber dam, indication for the restoration treatment, cavity class and clinical dimension of the cavity. After approximately two weeks (at visit 2), all the restorations were assessed and failure was defined if one of the following criteria occurred: a negative reaction to the vitality test, postoperative pain from masticatory forces or reported postoperative sensitivity by the patient. The reported postoperative sensitivity was specified with a visual analogue scale into hot/cold-sensitivity, sweet/sour- The statistical analysis showed that the clinical cavity depth turned out to be the only factor to have a significant influence on the appearance of postoperative sensitivity: caries profunda showed a four times higher risk of failure, while cavities with pulp exposure had a 14 times higher failure risk compared to restorations that were localized in the dentin. With regard to the type of sensitivity, no patients reported sensitivity to sweet/sour; most of them described their sensitivity as sharp/dull.

Non-destructive assessment of cavity wall adaptation of class V composite restoration using swept-source optical coherence tomography

“…Such a marginal gap and subsequent microleakage may lead to marginal staining 5,6) , postoperative sensitivity 7) , and secondary caries 8) . In addition, gaps along the cavity wall may lead to pain with biting 9) and failure of adhesion by repeated occlusal loading 10) . The traditional methods to detect gaps and subsequent leakage are the dye leakage test, the bacterial microleakage test, the electrochemical leakage test and the radioisotopes test 11) .…”

Post-operative sensitivity of Class I, II amalgam and composite resin restorations: Clinical evaluation in an undergraduate program

“…[15] This may lead to more pulpal insult and thermal connectivity to the pulp, so more POS is expected in deep cavities. Other studies [16,17] also shows that the more the depth of the cavity the more is the POS.…”

Cavity Adaptation of Water-Based Restoratives Placed as Liners under a Resin Composite

“…The use of 3D analysis of polymerization shrinkage of a dental composite and the resulting gap formation has also been performed using micro-XCT [22, 23]. Microleakage is one of the consequences for restoration failures as it induces sensitivity, leads to colonization of marginal openings by microorganisms, and may lead to recurrent caries and pulpal disease [24]. …”