Assessment of Postoperative Sensitivity in Direct Resin Composite Restorations with and Without Liners
DOI:
https://doi.org/10.36283/ziun-pjmd14-4/035Keywords:
Composite Resins, Tooth Sensitivity, Cavity Lining Agents, Randomized Controlled Trial, Postoperative Complications.Abstract
Background: Sensitivity after treatment is one of the most frequent complications with direct resin composite restoration work that can seriously affect patient comfort. Reduction of this sensitivity has been put forth by liners use, and their evidence is inadequate yet. The study aimed to develop and evaluate postoperative sensitivity of restorations done using liners and un-linered.
Methods: This comparative, randomized controlled study was generated between January and April 2025 at the Department of Operative Dentistry, [Name of Institution]. One hundred patients who were in Class I and II posterior corrected restorations were accepted, through consecutively non-probability sampling. The subjects were randomly assigned into either Group A which had resin composite restoration but included a cavity liner (calcium hydroxide or resin modified glass ionomer) or Group B which had no liner at all. To determine sensitivity, a visual analog scale (VAS) was assessed at baseline, 24 hours, 3 days and 7 days after surgery. The analysis of data was performed with SPSS 26.0, and independent t-tests and chi-square tests were employed. The p-value < 0.05 was taken to be statistically significant.
Results: The sensitivity of group A was considerably low at 24 hours, 3 days, and 7 days (p = 0.01, 0.003 and 0.0005 correspondingly) in comparison with group B. Less differences of baseline demographic or clinical parameters were observed.
Conclusion: Under the resin composite restoration, liners have been chosen successfully to alleviate the initially perceived postoperative sensitivity. The evidence can be used to include liners in the standard restorative practice.
References
1. Bhatti UA. The Phenomenon of Postoperative Sensitivity and Composite Restorations-A Review. J Pak Dent Assoc. 2019 Mar;28(1):33-40. doi: 10.25301/JPDA.281.33
2. Mushtaq U, Mushtaq F, Thakur D, Rathee K, Poonia N, Khullar S. Comparative evaluation of postoperative sensitivity following restoration of class I lesions with different restorative materials: an in vivo study. J Contemp Dent Pract. 2021 Aug 9;22(6):650-654. doi: 10.5005/jp-journals-10024-3085
3. Channa S, Rajput F, Bilgrami A, Javed F, Faraz H. Evaluation of Post-Operative Sensitivity of Nano Filled Composite Versus Bulk Filled Resin Composite in Posterior Class 2 Restoration: Post-Operative Sensitivity of Nano Filled Composite. Pak J Health Sci. 2023 Apr 30;4(4):14-18. doi: 10.54393/pjhs.v4i04.645.
4. Ayar MK. Postoperative sensitivity after placement of bulk-fill posterior restoration. J Res Med Dent Sci. 2017 Aug. 5 (3): 53-58. doi: 10.24896/jrmds.2017539
5. de Oliveira NG, Lima AS, da Silveira MT, de Souza Araújo PR, de Melo Monteiro GQ, de Vasconcelos Carvalho M. Evaluation of postoperative sensitivity in restorations with self-adhesive resin: a randomized split-mouth design controlled study. Clin Oral Invest. 2020 May;24(5):1829-1835. doi: 10.1007/s00784-019-03046-0.
6. Sear R, Rees J, Buller Z, Moore SC. The feasibility of characterising the effects of dental post-operative discomfort and sensitivity over time. J Dent. 2018 May;72:80-82. doi: 10.1016/j.jdent.2018.03.007.
7. Ferrando Cascales Á, Sauro S, Hirata R, Astudillo-Rubio D, Ferrando Cascales R, Agustín-Panadero R, et al. Total Rehabilitation Using Adhesive Dental Restorations in Patients with Severe Tooth Wear: A 5-Year Retrospective Case Series Study. J Clin Med. 2023 Aug 10;12(16):5222. doi: 10.3390/jcm12165222.
8. Torres CR, Mailart MC, Rocha RS, Sellan PL, Contreras SC, Di Nicoló R, et al. The influence of a liner on deep bulk-fill restorations: randomized clinical trial. J Dent. 2020 Nov 1;102:103454. Doi: 10.1016/j.jdent.2020.103454.
9. Ali M, Hussain S, Abdullah F, Baloch J, Soomro ZA, Sheikh A, et al. A comparison of post-operative sensitivity in composite resin restorations using total-etch and self-etch adhesive in posterior teeth. J Adv Med Med Res. 2020 Nov;32(23):1-6. doi: 10.9734/JAMMR/2020/v32i2330710.
10. Mundaragi VAC, Niranjan NT, Chandrashekhar KS, Rao DG, Patil TN, Chavan SC. Comparative Evaluation of Microleakage in Class II Composite Restorations Using Three Bulk-fill Composites with or without Resin-modified Glass Ionomer Cement Liner: A Stereomicroscopic Study. Int J Clin Pediatr Dent. 2024 Oct;17(10):1146-1152. doi: 10.5005/jp-journals-10005-2957.
11. Rajnekar R, Mankar N, Nikhade P, Chandak M, Ikhar A, Burde K, et al. Clinical efficacy of two different desensitizers in reducing postoperative sensitivity following composite restorations. Cureus. 2022 Jun 15;14(6). e25977. doi: 10.7759/cureus.25977.
12. Albar NHM, Khayat WF. Evaluation of Fracture Strength of Fiber-Reinforced Direct Composite Resin Restorations: An In Vitro Study. Polymers (Basel). 2022 Oct 15;14(20):4339. doi: 10.3390/polym14204339.
13. AlJarboua RT, Alshihry RA, Alkhaldi HO, Al Marar FH, Aljaffary MA, Almana ML, et al. Effect of Fiber-Reinforced Composite Placement Site on Fracture Resistance of Premolar Teeth: An in vitro Study. Clin Cosmet Investig Dent. 2024 Jul 8;16:255-266. doi: 10.2147/CCIDE.S461134.
14. Karaman E, Keskin B, Inan U. Three-year clinical evaluation of class II posterior composite restorations placed with different techniques and flowable composite linings in endodontically treated teeth. Clin Oral Investig. 2017 Mar;21(2):709-716. doi: 10.1007/s00784-016-1940-y.
15. Nikaido T, Tagami J, Yatani H, Ohkubo C, Nihei T, Koizumi H, et al. Concept and clinical application of the resin-coating technique for indirect restorations. Dent Mater J. 2018 Mar 30;37(2):192-196. doi: 10.4012/dmj.2017-253.
16. Mine A, Nikaido T, Matsumoto M, Takagaki T, Ishida M, Ban S, et al. Status of decontamination methods after using dentin adhesion inhibitors on indirect restorations: An integrative review of 19 publications. Jpn Dent Sci Rev. 2021 Nov;57:147-153. doi: 10.1016/j.jdsr.2021.08.001.
17. Josic U, Sebold M, Lins RBE, Savovic J, Mazzitelli C, Maravic T, et al. Does immediate dentin sealing influence postoperative sensitivity in teeth restored with indirect restorations? A systematic review and meta-analysis. J Esthet Restor Dent. 2022 Jan;34(1):55-64. doi: 10.1111/jerd.12841.
18. Staněk J, Riad A, Le A, Bernát M, Hammal M, Azar B. Survival of Prosthodontic Restorations Luted with Resin-Based versus Composite-Based Cements: Retrospective Cohort Study. Materials (Basel). 2022 Jan 2;15(1):312. doi: 10.3390/ma15010312.
19. Borgia E, Baron R, Borgia JL. Quality and Survival of Direct Light-Activated Composite Resin Restorations in Posterior Teeth: A 5- to 20-Year Retrospective Longitudinal Study. J Prosthodont. 2019 Jan;28(1):e195-e203. doi: 10.1111/jopr.12630.
20. Nguyen AD, Pütz N, Michaelis M, Bitter K, Gernhardt CR. Influence of Cavity Lining on the 3-Year Clinical Outcome of Posterior Composite Restorations: A Randomized Controlled Clinical Trial. Dent J. 2024 May 7;12(5):128 doi: 10.3390/dj12050128.
21. Ghodsi S, Shekarian M, Aghamohseni MM, Rasaeipour S, Arzani S. Resin cement selection for different types of fixed partial coverage restorations: A narrative systematic review. Clin Exp Dent Res. 2023 Dec;9(6):1096-1111. doi: 10.1002/cre2.761.
22. Rodrigues NS, De Souza LC, Cunha DA, Souza NO, Silva PG, Santiago SL, et al. Postoperative sensitivity of composite replacement of amalgam restoration: a randomized clinical trial. Oper Dent. 2022 Sep 1;47(5):481-491. doi: 10.2341/19-295-C
23. Cardoso RM, De Veras BM, da Silva Pedrosa M, Da Silva CH. Clinical Evaluation of Postoperative Sensitivity in Class I Resin Composite Restorations. Braz Dent Sci. 2020 Sep 30;23(4):8p. doi: 10.14295/bds.2020.v23i4.2048.
24. Blum IR, Younis N, Wilson NH. Use of lining materials under posterior resin composite restorations in the UK. J Dent. 2017 Feb 1;57:66-72. doi: 10.1016/j.jdent.2016.12.008.
25. Maghaireh GA, Albashaireh ZS, Allouz HA. Postoperative sensitivity in posterior restorations restored with self-adhesive and conventional bulk-fill resin composites: A randomized clinical split-mouth trial. J Dent. 2023 Oct 1;137:104655. doi: 10.1016/j.jdent.2023.104655.
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