POST-OPERATIVE SENSITIVITY IN COMPOSITES USING BULK-FILL VS. OBLIQUE INCREMENTAL PLACEMENT TECHNIQUE: A DOUBLE-BLIND, RANDOMIZED TRIAL

Authors

  • Nehal Amir School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad-Pakistan
  • Hashim Bin Mansoor Army Medical College, National University of Medical Sciences, Rawalpindi-Pakistan
  • Haider Rizwan School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad-Pakistan
  • Maimoona Azhar Fatima Jinnah Dental College, Jinnah Sindh Medical University, Karachi-Pakistan
  • Ayman Ijaz School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad-Pakistan
  • Khadim Hussain Islamia University, Bahawalpur-Pakistan

DOI:

https://doi.org/10.55519/JAMC-01-13487

Abstract

Background Post-operative sensitivity is a potential drawback of composite restorations. Placement strategies have a profound impact on sensitivity. This trial is aimed to compare the occurrence and severity of sensitivity in composites using bulk-fill technique and oblique incremental technique. Methods This double-blind, randomized clinical trial was conducted at the Department of Operative Dentistry and Endodontics, School of Dentistry, Islamabad from December 20, 2022, to July 24, 2023. A total of  90 participants with moderate-sized Class II carious lesions were recruited and randomly distributed into two groups A and B (n=45). After informed consent, restorative intervention was accomplished using an etch-and-rinse adhesive strategy. In group A, a nanohybrid composite resin was placed using an oblique incremental strategy with a thickness of 2 mm while in group B, bulk-fill strategy was employed with a thickness of 4 mm. Participants were instructed to rate their sensitivity status at evaluation periods using Visual analogue scale. Data was analyzed using the Independent Sample T-test. The level of significance was calibrated at ≤0.05. Results According to results of this trial, a significant difference was discerned between two groups after one day (p=0.00) and one week (p=0.01). Nonetheless, the statistical contrast between two groups was not as significant (p=0.05) after two weeks period. Conclusion In conclusion, post-operative sensitivity at all three-time intervals using Bulk-fill technique was reported to be less than Oblique incremental approach. This corroborates the claim that utilizing the bulk-fill strategy for composite restoration mitigates post-operative discomfort.

References

1. Bhatti UA. The phenomenon of postoperative sensitivity and composite restorations: a review. J Pak Dent Assoc 2019;28(1):33–40.

2. Fugolin APP, Pfeifer CS. New resins for dental composites. J Dent Res 2017;96(10):1085–91.

3. Sabbagh J, Fahd JC, McConnell RJ. Post-operative sensitivity and posterior composite resin restorations: a review. Dent Update 2018;45(3):207–13.

4. Ayar MK. Postoperative sensitivity after placement of bulk-fill posterior restoration. J Res Med Dent Sci 2017;5(3):53–8.

5. Loguercio AD, Rezende M, Gutierrez MF, Costa TF, Armas-Vega A, Reis A. Randomized 36-month follow-up of posterior bulk-filled resin composite restorations. J Dent 2019;85:93–102.

6. Rudrapati L, Chandrasekhar V, Badami V, Tummala M. Incremental techniques in direct composite restoration. J Conserv Dent 2017;20(6):386–91.

7. Chesterman J, Jowett A, Gallacher A, Nixon P. Bulk-fill resin-based composite restorative materials: a review. Br Dent J 2017;222(5):337–44.

8. Tardem C, Albuquerque EG, Lopes LS, Marins SS, Calazans FS, Poubel LA, et al. Clinical time and postoperative sensitivity after use of bulk-fill (syringe and capsule) vs. incremental filling composites: a randomized clinical trial. Braz Oral Res 2019;33:e0089.

9. Afifi SMH, Haridy MF, Farid MR. Evaluation of post-operative sensitivity of bulk fill resin composite versus nano resin composite: a randomized controlled clinical study. Open Access Maced J Med Sci 2019;7(14):2335–42.

10. Channa S, Rajput F, Bilgrami A, Javed F, Faraz H, Madiha. Evaluation of post-operative sensitivity of nano filled composite versus bulk filled resin composite in posterior Class 2 restoration. Pak J Health Sci 2023;4(4):14–8.

11. de Oliveira ILM, Hanzen TA, de Paula AM, Perdigão J, Montes MAJR, Loguercio AD, et al. Postoperative sensitivity in posterior resin composite restorations with prior application of a glutaraldehyde-based desensitizing solution: a randomized clinical trial. J Dent 2022;117:103918.

12. Asghar S, Ali A, Rashid S, Hosein T. Assessment of post-operative sensitivity in posterior resin-based composite restorations with two placement techniques. J Pak Dent Assoc 2013;22(2):98–103.

13. de Assis FS, Lima SN, Tonetto MR, Bhandi SH, Pinto SC, Malaquias P, et al. Evaluation of bond strength, marginal integrity, and fracture strength of bulk- vs incrementally-filled restorations. J Adhes Dent 2016;18(4):317–23.

14. Van Dijken JW, Pallesen U. Posterior bulk-filled resin composite restorations: a 5-year randomized controlled clinical study. J Dent 2016;51:29–35.

15. Bayraktar Y, Ercan E, Hamidi MM, Çolak H. One-year clinical evaluation of different types of bulk-fill composites. J Investig Clin Dent 2017;8(2):e12210.

16. Costa T, Rezende M, Sakamoto A, Bittencourt B, Dalzochio P, Loguercio AD, et al. Influence of adhesive type and placement technique on postoperative sensitivity in posterior composite restorations. Oper Dent 2017;42(2):143–54.

17. Arbildo-Vega HI, Lapinska B, Panda S, Lamas-Lara C, Khan AS, Lukomska-Szymanska M. Clinical effectiveness of bulk-fill and conventional resin composite restorations: systematic review and meta-analysis. Polymers (Basel) 2020;12(8):1786.

18. Sengupta A, Naka O, Mehta SB, Banerji S. The clinical performance of bulk-fill versus the incremental layered application of direct resin composite restorations: a systematic review. Evid Based Dent 2023;24(3):143.

19. Yousaf A, Aman N, Manzoor MA, Shah JA, Dilrasheed. Postoperative sensitivity of self-etch versus total-etch adhesive. J Coll Physicians Surg Pak 2014;24(6):383–6.

20. Reis A, Loguercio AD, Schroeder M, Luque-Martinez I, Masterson D, Maia LC. Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?: a systematic review and meta-analysis. Dent Mater 2015;31(11):1331–49.

Published

2025-06-15

How to Cite

1.
Amir N, Mansoor HB, Rizwan H, Azhar M, Ijaz A, Hussain K. POST-OPERATIVE SENSITIVITY IN COMPOSITES USING BULK-FILL VS. OBLIQUE INCREMENTAL PLACEMENT TECHNIQUE: A DOUBLE-BLIND, RANDOMIZED TRIAL. J Ayub Med Coll Abbottabad [Internet]. 2025 Jun. 15 [cited 2025 Jul. 26];37(2). Available from: https://jamc.ayubmed.edu.pk/index.php/jamc/article/view/13487