Postoperative Sensitivity of Composite Replacement of Amalgam Restoration: A Randomized Clinical Trial.

PURPOSE: This randomized clinical trial aimed to evaluate the postoperative sensitivity of different resin composite/adhesive materials, placed either by an incremental or bulk-fill technique in posterior resin composite replacement of amalgam restorations. METHODS AND MATERIALS: A total of 47 patients with good overall health and at least four class I or class II amalgam restorations to be replaced participated in this study. The characteristics of 188 cavities were registered and randomly restored using incremental (Z350XT, 3M) or bulk-fill (Filtek Bulk Fill, 3M; Sonic Fill, Kerr; and Opus Bulk Fill, FGM) technique. The postoperative sensitivity was assessed using a Visual Analog Scale (0-100) after 24 hours, 7 days, and 30 days. Pain scores were temporally analyzed using Friedman test followed by Dunn post hoc test (α=0.05). The frequency of tests was calculated according to the frequency and percentage of the McNemar test. RESULTS: The restorative technique and the bulk-fill system used did not affect the postoperative sensitivity, except for Filtek Bulk Fill group, which presented less postoperative sensitivity after 24 hours (p=0.037). Regardless of the restorative material, the postoperative sensitivity decreased after 24 hours, and no differences were found after 7 and 30 days. CONCLUSIONS: After 1 week, the filling technique and the bulk-fill system have no influence on the postoperative sensitivity.

Catechin-based Dentin Pretreatment and the Clinical Performance of a Universal Adhesive: A Two-year Randomized Clinical Trial.

CLINICAL RELEVANCE: At 24 months, the dentin pretreatment with epigallocatechin-3-gallate did not impair the clinical performance of the adhesive Single Bond Universal regardless of the bonding strategy used. SUMMARY: Purpose: To evaluate the two-year effect of dentin pretreatment with epigallocatechin-3-gallate (EGCG) on the clinical performance of restorations of noncarious cervical lesions (NCCLs) with Single Bond Universal, applied in two different modes (self-etch and etch-and-rinse).Methods and Materials: In this randomized clinical trial, 33 volunteers were selected, and 156 NCCLs were assigned to four groups: ER, etch-and-rinse; ER-EGCG, 0.1% EGCG dentin pretreatment + etch-and-rinse; SE, self-etch; and SE-EGCG, 0.1% EGCG dentin pretreatment + self-etch. The NCCLs were restored with a nanofilled resin composite and evaluated at baseline and at six, 12, 18, and 24 months using FDI criteria for retention, marginal staining, marginal adaptation, caries, and postoperative sensitivity. Two evaluators were blinded to the treatments performed, and impressions were taken for resin replicas to allow indirect observations. Statistical analyses were performed with Kruskal-Wallis and McNemar tests with a significance level of 5%.Results: Six restorations (one from ER, two from SE, one from ER-EGCG, and two from SEEGCG) were lost at 24 months with no significant differences (p>0.05). The retention rates were 97.0% (ER and ER-EGCG), 94.1% (SE), and 94.2% (SE-EGCG). For marginal adaptation, a significant difference was detected between the baseline and 24 months for the SE group (p=0.0313). There were no statistical differences among all other evaluated criteria at 24 months, neither for each group at baseline nor for 24-month comparisons (p>0.05).Conclusions: The pretreatment with EGCG provided no benefit in the clinical performance of the adhesive regardless of the bonding strategy used. In addition, it adds an additional required step to the restorative procedure.