Postoperative dentinal sensitivity following four restorative strategies in vital posterior teeth: a randomized controlled trial
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Abstract
Objective: To compare postoperative dentinal sensitivity following restoration of vital posterior teeth using four restorative strategies: total-etch resin composite, self-etch resin composite, high-strength glass ionomer cement (GIC), and bioactive resin restoration over a three-month follow-up period.
Methods: This single-center, parallel-group randomized controlled trial included 160 participants aged 18–40 years with Class I or Class II cavities in permanent molars. Participants were randomly allocated to four restorative groups (n=40 each). Postoperative dentinal sensitivity was assessed using a modified 100-mm Visual Analogue Scale at 24 hours, 48 hours, 7 days, and 3 months. Between-group comparisons were performed using non-parametric tests, with stratified subgroup analyses according to gender and cavity class.
Results: Postoperative dentinal sensitivity decreased substantially over time in all restorative groups. At 24 hours, the self-etch resin composite demonstrated significantly lower sensitivity than the other restorative materials (p<0.001), whereas the high-strength GIC group exhibited the highest postoperative sensitivity (p<0.001). No significant difference was observed between the total-etch resin composite and bioactive resin groups (p=1.000). At three months, postoperative sensitivity was comparable among the total-etch, self-etch, and bioactive resin groups, while the high-strength GIC group continued to demonstrate significantly greater sensitivity than the other restorative strategies (p<0.001). Male participants and Class I restorations showed significantly higher postoperative sensitivity within GIC group.
Conclusion: Self-etch resin composite was associated with the lowest immediate postoperative dentinal sensitivity, whereas high-strength GIC demonstrated significantly greater postoperative sensitivity that persisted at three months. Total-etch resin composite and bioactive resin restoration showed comparable short- and long-term clinical performance.
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