A Comparison of Post-operative Sensitivity in Composite Resin Restorations Using Total-etch and Self-etch Adhesive in Posterior Teeth

Aims: Over the period of time lot of advancement has been done in the field of dentistry. In spite of these newer materials and improvement in the properties of composite material post-operative sensitivity is still a major concern for a dentist after composite restoration placement. Dentine bonding agents; dentine adhesives are either a “total-etch technique” or “self-etch technique” which bond to the tooth structure. The purpose of this study was to evaluate the clinical efficacy of self -etch and total-etch with strict inclusion and exclusion criteria. Self-etching adhesives are used to prevent postoperative sensitivity when used before placing posterior resin-based composite restorations. The purpose of this study was to see whether self-etch adhesive would result in less postoperative sensitivity than a total-etch adhesive; Total Etch adhesive would result in a better enamel marginal integrity than Self Etch Adhesive.

Study Design: Clinical Trial.

Place and Duration of Study: Department of Operative Dentistry, Fatima Jinnah Dental College between October 2019 – February 2020.

Methodology: Sample size was calculated using a WHO sample size determination for health studies software using power 80% and the level of significance 5%. Sample size was calculated in accordance with the literature review. The sample size required was 32 in each group. Sample technique was Non-probability purposive sampling. Total 62 teeth were restored (molars and premolars) 32 in each group, age range 18 to 40 years. Cross tab made for the pain score between self-etch and total etch or pain comparison. Man Whitney test was applied. Both adhesives were handled and applied according to manufacturer’s instructions. The patients were carefully examined at recall appointments at 2 weeks, 4 weeks and 3 months.

Results: Total 62 teeth were restored (molars and premolars) 32 in each group. On the basis of frequency and percentage clinically significant difference was found but no significance was found. Patients were evaluated before treatment, 2 weeks after treatment and 3 months after treatment. When compared the sensitivity severity with self-etch technique 19.4% had moderate sensitivity before treatment which was reduced to 0% after 2 weeks and 3 months. While in total etch technique there was 16.1% sensitivity preoperatively which was reduced to 3.2% and 6.5% after 2 weeks and 3 months respectively.

Conclusion: There is lesser degree of sensitivity when total etch technique was used under composite in comparison to self-etch.