Campbell I, Kang J, Hyde T P
1 Scunthorpe, UK.
2 School of Dentistry, University of Leeds, Leeds, UK.
JDR Clin Trans Res. 2017 Jul;2(3):295-303. doi: 10.1177/2380084416682934. Epub 2016 Dec 20.
Physical properties of composite improve when it is preheated prior to polymerization. However, postoperative sensitivity may be considered a potential complication. A review of the literature revealed no reported randomized controlled trials (RCTs) of postoperative sensitivity when using preheated composite resin. The objective of the study was to determine if preheating composite leads to changes in postoperative sensitivity in a parallel RCT. In total, 120 eligible, consenting adults were recruited in private dental practice and randomized into 2 groups of 60 patients. One group had room temperature composite restorations placed and the second had composite preheated to 39°C. The primary outcome was sensitivity after 24 h by the visual analog scale (VAS), recorded blind by patients. Secondary outcomes were VAS scores recorded over a month. Blind statistical analysis used the Mann-Whitney U test to compare the 24-h VAS score between groups and repeated-measures analysis of variance to assess the change over time. Potential confounders were tested using regression models. A total of 115 patients completed the trial: 57 in the heated composite group and 58 in the room temperature group. Analysis of 24-h VAS scores found no statistically significant difference between the 2 groups ( P = 0.162). Examining the potential confounders confirmed the nonsignificant difference between heated and room temperature groups on the 24-h VAS score, after controlling teeth type and preoperative pulp test (effect size = 0.173, P = 0.317). Analysis of the secondary outcomes found significant changes (within-subject effect) in VAS scores over the review period ( F statistic = 4.7, P = 0.002) but not a significant (between-subject effect) difference between heated and room temperature groups over time (effect size = 0.102, P = 0.197). There was a significant correlation between preoperative VAS score and postoperative VAS score ( P < 0.001). For the restorations in this study, there was no detectable difference in postoperative VAS score between preheated and room temperature composite. Postoperative sensitivity decreased throughout the first month. Postoperative sensitivity was correlated to preoperative sensitivity (ISRCTN 76727312). Knowledge Transfer Statement: The results of this study can be used by clinicians when considering the advantages and disadvantages of preheated composite. The study found no evidence of any change in postoperative sensitivity when using preheated composite. Since preheated composite has superior physical properties, its use for routine care can be considered good practice.
复合树脂在聚合前预热时其物理性能会得到改善。然而，术后敏感可能被视为一种潜在并发症。对文献的回顾显示，尚无关于使用预热复合树脂后术后敏感的随机对照试验（RCT）报道。本研究的目的是在一项平行RCT中确定预热复合树脂是否会导致术后敏感的变化。总共120名符合条件且同意参与的成年人在私人牙科诊所被招募，并随机分为两组，每组60名患者。一组进行室温复合树脂修复，另一组将复合树脂预热至39°C。主要结局是24小时后患者通过视觉模拟量表（VAS）记录的敏感度，由患者在不知情的情况下记录。次要结局是在一个月内记录的VAS评分。不知情的统计分析使用Mann-Whitney U检验比较两组之间的24小时VAS评分，并使用重复测量方差分析评估随时间的变化。使用回归模型测试潜在的混杂因素。共有115名患者完成了试验：加热复合树脂组57名，室温组58名。对24小时VAS评分的分析发现两组之间无统计学显著差异（P = 0.162）。检查潜在混杂因素证实，在控制牙齿类型和术前牙髓测试后，加热组和室温组在24小时VAS评分上无显著差异（效应量 = 0.173，P = 0.317）。对次要结局的分析发现，在整个观察期内VAS评分有显著变化（受试者内效应）（F统计量 = 4.7，P = 0.002），但加热组和室温组随时间无显著差异（受试者间效应）（效应量 = 0.102，P = 0.197）。术前VAS评分与术后VAS评分之间存在显著相关性（P < 0.001）。对于本研究中的修复体，预热复合树脂和室温复合树脂在术后VAS评分上无可检测到的差异。术后敏感在第一个月内逐渐降低。术后敏感与术前敏感相关（ISRCTN 76727312）。知识转移声明：临床医生在考虑预热复合树脂的优缺点时可使用本研究结果。该研究未发现使用预热复合树脂后术后敏感有任何变化的证据。由于预热复合树脂具有优越的物理性能，将其用于常规护理可被视为良好做法。
