Dental School, Universidade de Pernambuco, Pernambuco, PE, Brazil; Instituto de Tecnologia de Pernambuco - ITEP/ Block B 1st floor. Av. Prof. Luis Freire, 700 - Cidade Universitária, Recife-PE, Brazil 50740-540.
Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Campus Uvaranas - Bloco M - 52B 2° Piso, General Carlos Cavalcanti Avenue, 4748 - Ponta Grossa - PR, 84030-900, Brazil.
J Dent. 2022 Feb;117:103918. doi: 10.1016/j.jdent.2021.103918. Epub 2021 Dec 5.
To evaluate the effect of a glutaraldehyde-based desensitizer on the postoperative sensitivity (POS) in posterior resin composite restorations up to 12 months using a universal adhesive (Tetric N-Bond Universal) with selective enamel etching (SE) or an etch-and-rinse (ER) strategy.
Class I and class II resin composite restorations (n = 220) at least 3 mm deep were inserted in 55 subjects. The universal adhesive was applied using the SE (self-etch strategy on dentin with selective enamel etching) or the ER strategy, with or without prior application of a glutaraldehyde-based desensitizer (Gluma Desensitizer - GL) to form groups SEGL and ERGL. A bulk-fill resin composite (Tetric NCeram Bulk Fill) was used for all restorations. Spontaneous POS was assessed 7 days after the restorative procedure using the Visual Analog Scale (VAS) and the Numeric Rating Scale (NRS). After 7, 14, and 30 days of completing each restoration, the subjects were reassessed to evaluate POS caused by stimulation with an air blast, horizontal and vertical percussion. In addition, marginal discoloration, marginal adaptation, fracture, and recurrence of caries were evaluated using the FDI (World Dental Federation) criteria after 7 days and at 12 months.
No significant spontaneous or stimuli-induced POS was observed when restorations with or without GL were compared (p>0.05). A higher risk of spontaneous POS was observed within 7 days (40.0%; 95% CI 28.1 to 53.1), without statistically significant differences among groups. None of the participants reported POS at 12 months, however five restorations were considered clinically unsatisfactory (p > 0.05).
The previous application of GL did not significantly reduce spontaneous or stimuli-induced POS in posterior resin composite restorations at any time, regardless of the adhesive strategy used.
The use of a glutaraldehyde-based desensitizing agent did not generate lower incidence of postoperative sensitivity in resin composite posterior restorations.
使用通用粘结剂（Tetric N-Bond Universal）联合选择性釉质酸蚀（SE）或酸蚀-冲洗（ER）技术，评估戊二醛基脱敏剂对术后敏感性（POS）的影响，研究对象为使用 SE 或 ER 技术并联合或不联合戊二醛基脱敏剂（Gluma Desensitizer-GL）的后牙复合树脂修复体，随访时间长达 12 个月。
共纳入 55 名患者的 220 个 CLASS I 和 CLASS II 窝洞，深度至少 3mm。所有窝洞均使用通用粘结剂（Tetric N-Bond Universal）进行粘结，粘结方式包括 SE（自酸蚀粘结剂选择性酸蚀釉质）或 ER（酸蚀-冲洗粘结剂），联合或不联合戊二醛基脱敏剂（Gluma Desensitizer-GL）。所有修复体均使用块状充填复合树脂（Tetric NCeram Bulk Fill）。在修复后第 7 天，通过视觉模拟评分（VAS）和数字评分量表（NRS）评估自发性 POS，第 7、14 和 30 天评估空气刺激、水平和垂直叩诊刺激诱发的 POS。此外，在修复后第 7 天和 12 个月时，采用世界牙科联合会（FDI）标准评估边缘着色、边缘密合度、折裂和继发龋情况。
无论是否使用 GL，修复体间自发性或刺激诱发的 POS 无显著差异（p>0.05）。第 7 天内自发性 POS 风险较高（40.0%；95%CI 28.1%至 53.1%），但各组间无统计学差异。所有患者在第 12 个月时均未报告 POS，但 5 个修复体被认为临床效果不佳（p>0.05）。
在后牙复合树脂修复中，无论粘结方式如何，在任何时间点，使用 GL 预处理均不能显著降低自发性或刺激诱发的 POS。
使用戊二醛基脱敏剂不能降低后牙复合树脂修复体的术后敏感性发生率。
