Effect of Incremental Techniques in Direct Composite Restoration on Post-Operative Hypersensitivity
DOI:
https://doi.org/10.61919/jhrr.v4i2.1762Keywords:
Composite Resins, Polymerization Shrinkage, Postoperative Pain, Tooth Hypersensitivity, Dental Bonding, Incremental Technique, Visual Analog ScaleAbstract
Background: Post-operative hypersensitivity is a common complication of direct composite restorations, often caused by polymerization shrinkage and microleakage. Incremental composite placement techniques and desensitizing agents have been proposed to mitigate this issue.
Objective: To evaluate the effectiveness of incremental composite layering and desensitizing agents in reducing post-operative hypersensitivity in Class I direct composite restorations.
Methods: This randomized clinical study was conducted at the Department of Operative Dentistry, Bolan Medical College, Quetta, from August 2021 to February 2022. A total of 60 patients were randomly assigned to three groups: Gluma (n=20), SAD (n=20), and Control (n=20). Class I cavities were prepared using standardized protocols, and restorations were performed using Tetric N-Ceram composite resin with a universal bonding system. Hypersensitivity was assessed using the Visual Analog Scale (VAS) at 24 hours, 7 days, and 30 days post-operatively. Data were analyzed using SPSS version 25, with one-way ANOVA and t-tests applied for statistical comparisons.
Results: VAS scores were significantly lower in the incremental technique group (2.1 ± 1.3 at 24 hours, 1.5 ± 1.1 at 7 days, 1.1 ± 0.9 at 30 days) compared to the conventional technique (4.2 ± 2.1, 3.5 ± 1.9, 2.9 ± 1.7, respectively; p<0.05). Hypersensitivity incidence was also reduced in the incremental group (10%, 6%, and 4% at respective time points) versus the conventional group (30%, 24%, and 20%, p<0.05).
Conclusion: Incremental composite placement significantly reduced post-operative hypersensitivity, particularly when combined with desensitizing agents, emphasizing its clinical importance in enhancing patient comfort.
Downloads
References
Campbell I, Kang J, Hyde TP. Randomized Controlled Trial of Postoperative Sensitivity with Warm and Room Temperature Composite. JDR Clinical & Translational Research. 2016;2(3):295-303.
Costa TRF, Rezende M, Sakamoto A, Bittencourt B, Dalzochio P, Loguercio AD, et al. Influence of Adhesive Type and Placement Technique on Postoperative Sensitivity in Posterior Composite Restorations. Oper Dent. 2017;42(2):143-54.
Rudrapati L, Chandrasekhar V, Badami V, Tummala M. Incremental techniques in direct composite restoration. Journal of Conservative Dentistry. 2017;20(6):386.
Singhal S. Effect of Different Composite Restorations on the Cuspal Deflection of Premolars Restored with Different Insertion Techniques- An In vitro Study. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. 2017.
Betamar N, Shah R. Effect of Soft-start Curing Mode on Postoperative Hypersensitivity of Class I Posterior Composites Restorations. Libyan Journal of Dentistry. 2018;2(2).
Sabbagh J, Fahd JC, McConnell RJ. Post-operative sensitivity and posterior composite resin restorations: a review. Dent Update. 2018;45(3):207-13.
Aboelenein AZ, Riad MI, Haridy MF. Effect of a Self-Etch Adhesive Containing Nanobioglass on Postoperative Sensitivity of Posterior Composite Restorations - A Randomized Trial. Open Access Macedonian Journal of Medical Sciences. 2019;7(14):2313-20.
Afifi SMH, Haridy MF, Farid MR. Evaluation of Post-Operative Sensitivity of Bulk Fill Resin Composite versus Nano Resin Composite: A Randomized Controlled Clinical Study. Open Access Macedonian Journal of Medical Sciences. 2019;7(14):2335-42.
Al-Sheikh R. Effects of Different Application Techniques on Nanohybrid Composite Restorations Clinical Success. The Open Dentistry Journal. 2019;13(1):228-35.
Mohammed F, A A, V A. Effect of Multilayering Incremental Technique on the Microleakage of High-viscosity Bulk-fill Composite Restorations in Endodontically Treated Teeth. J Contemp Dent Pract. 2019.
Tardem C, Albuquerque EG, Lopes LIdS, Marins SS, Calazans FS, Poubel LA, et al. Clinical time and postoperative sensitivity after use of bulk-fill (syringe and capsule) vs. incremental filling composites: a randomized clinical trial. Brazilian Oral Research. 2019;33.
Muhammad A, Samreen H, Faryal A, J B, Zaheer AS, A S, et al. A Comparison of Post-operative Sensitivity in Composite Resin Restorations Using Total-etch and Self-etch Adhesive in Posterior Teeth. 2020.
Boruziniat A, Alizadeh S, Gifani M, Cehreli ZC, Khazaei Y. The effect of ethanol wet bonding technique on postoperative hypersensitivity of Class II composite restorations. Dent Res J (Isfahan). 2021;18(1):97.
Burke FJT, Mackenzie L, Sands P, Shortall ACC. Ten tips for avoiding post-operative sensitivity with posterior composite restorations. Dent Update. 2021;48(10):823-32.
El-Ghany AAA, Elsayed HM, Goda AA, Abogabal AD, Sadek GEM, Dewedar KSA. Effect of two desensitizing agents on post-operative hypersensitivity of composite resin restorations. International journal of health sciences. 2021:763-9.
Rathee K, Mushtaq U, Mushtaq F, Thakur D, Poonia N, Khullar S. Comparative Evaluation of Postoperative Sensitivity Following Restoration of Class I Lesions with Different Restorative Materials: An In Vivo Study. The Journal of Contemporary Dental Practice. 2021;22(6):650-4.
Abd El-ghany A, Alsamoully W, Mosaad GE, Hafez M. Comparing Post-Operative Pain of Nanohybrid and Bulk Fill Composite Resin Restorations (In-vivo Study). Al-Azhar Assiut Dental Journal. 2022;5(2):193-9.
Rajnekar R, Mankar N, Nikhade P, Chandak M, Ikhar A, Burde K. Clinical Efficacy of Two Different Desensitizers in Reducing Postoperative Sensitivity Following Composite Restorations. Cureus. 2022.
Rodrigues NS, de Souza LC, Cunha DA, Souza NO, Silva PGB, Santiago SL, et al. Postoperative Sensitivity of Composite Replacement of Amalgam Restoration: A Randomized Clinical Trial. Oper Dent. 2022;47(5):481-91.
Sayed ME, Dewan H, Kharaf R, Athlawi M, Alfaifi M, Mugri MH, et al. Efficacy of Three Commercially Available Desensitizers in Reducing Post-Operative Sensitivity Following Composite Restorations: A Randomized Controlled Clinical Trial. Polymers. 2022;14(7):1417.
Channa S, Rajput F, Bilgrami A, Javed F, Faraz H, Madiha. Evaluation of Post- Operative Sensitivity of Nano Filled Composite Versus Bulk Filled Resin Composite in Posterior Class 2 Restoration. Pakistan Journal of Health Sciences. 2023:14-8.
Hassan KA, Khier SE. The first composite increment: Dependency on placement technique for interaction behavior with maturing dentin-adhesive bond at pulpal floors in deep occlusal cavities -- A comprehensive review. Saudi Journal of Oral Sciences. 2024;11(2):73-83.
Shah RD, Patel NK, Shah SS, Kesharani PR, Doshi PR, Shah VD. Impact of different light curing mode on post-operative hypersensitivity after Class I composite restorations: A randomized clinical trial. IP Indian Journal of Conservative and Endodontics. 2024;9(4):167-72.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Sadia Malik, Syed Attaullah Shah, Shazmeen Alim, Sangeen Ameer, Farhat Fatima, Fakhira Nizam
This work is licensed under a Creative Commons Attribution 4.0 International License.
Public Licensing Terms
This work is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). Under this license:
- You are free to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material) for any purpose, including commercial use.
- Attribution must be given to the original author(s) and source in a manner that is reasonable and does not imply endorsement.
- No additional restrictions may be applied that conflict with the terms of this license.
For more details, visit: https://creativecommons.org/licenses/by/4.0/.
