Hickey D, Sharif O, Janjua F, Brunton P A
General Dental Practitioner, Chorley, Lancashire, UK.
Orthodontist, Eastman Dental Hospital, London, UK.
J Dent. 2016 Mar;46:18-22. doi: 10.1016/j.jdent.2016.01.011. Epub 2016 Jan 27.
This randomized controlled clinical trial compared two techniques and materials for restoring carious teeth-Bulk dentine replacement versus incremental placement of a hybrid posterior resin composite material in terms of patient comfort (post operative sensitivity and tenderness on biting).
Seventy-two carious teeth were randomized to one of two treatment groups: Group A-were restored with a bulk dentine replacement material or Group B-restored with incrementally placed hybrid composite. Patients were followed up by way of a structured phone call at day 2 and day 7 post-operatively. Patients reporting discomfort at day 7 were subsequently followed up on days 14, and 30.
All patients were followed up. At day 2, 18/72 restored teeth had post-operative sensitivity; this figure fell to 10/72 at day 7. A Chi squared test revealed that at day 2 a greater level of sensitivity was reported by patients in Group A (P=0.029). However, at day 7 there was no statistically significant difference between the two groups in terms of sensitivity (P=0.453). 8/72 and 6 /72 teeth had tenderness to biting at days 2 and 7 respectively. A Chi squared test revealed no statistically significant difference between the two groups in terms of tenderness on biting at any time period (P=0.722). Interestingly, Class I cavities were found to be more tender on biting than Class II cavities. At day 30 2/72 teeth exhibited sensitivity and none of the teeth exhibiting tenderness on biting.
At day 7 there was no significant difference between the two groups in terms of postoperative sensitivity and tenderness on biting.
本随机对照临床试验比较了两种治疗龋齿的技术和材料——大块牙本质替代法与混合后牙树脂复合材料分层充填法，比较指标为患者舒适度（术后敏感性和咬合压痛）。
72颗龋齿被随机分为两个治疗组之一：A组用大块牙本质替代材料修复，B组用混合复合材料分层充填修复。术后第2天和第7天通过结构化电话随访患者。术后第7天报告有不适的患者随后在第14天和第30天接受随访。
所有患者均得到随访。术后第2天，72颗修复牙中有18颗有术后敏感性；这一数字在术后第7天降至10/72。卡方检验显示，术后第2天A组患者报告的敏感性水平更高（P=0.029）。然而，在术后第7天，两组之间在敏感性方面无统计学显著差异（P=0.453）。术后第2天和第7天分别有8/72和6/72颗牙有咬合压痛。卡方检验显示，在任何时间段，两组之间在咬合压痛方面均无统计学显著差异（P=0.722）。有趣的是，发现Ⅰ类洞比Ⅱ类洞在咬合时更压痛。在术后第30天，72颗牙中有2颗表现出敏感性，没有牙齿表现出咬合压痛。
在术后第7天，两组在术后敏感性和咬合压痛方面无显著差异。
