Postoperative hypersensitivity in Class I RBC restorations: a PEARL Study

Objective: Report preliminary findings from an ongoing study to determine the incidence of patient-reported postoperative hypersensitivity associated with Class I resin-based composite (RBC) restoration of posterior teeth and to relate these findings to dentin caries characteristics.

Methods: Thirty-four PEARL Practitioner-Investigators enrolled patients with early/shallow caries (<¨ö dentin thickness on radiograph) and restored lesions using their preferred technique. Before restoration and at 1, 4, and 13 weeks postoperatively patients completed a hypersensitivity questionnaire related to the study tooth (6 questions, 5 with 0-10 anchored VAS pain scale). Appreciable hypersensitivity (AH) is defined as a score of °Ã3 on any VAS question. Dentists ranked dentin caries activity upon opening enamel and measured preparation depth and volume; multiple teeth from a single individual were treated as independent.

Results: Of the 288 restored teeth (600 planned) in 249 patients (median age 24 years, range 10-59), 90% were molars and 10% second premolars; 60% in lower quadrants. At baseline, 53.8% (147/273) of teeth had some hypersensitivity and 31.5% (86/273) had AH. One week postoperatively, 26.3% of all teeth remaining to follow-up (54/205) had AH. Among teeth with no baseline AH 18.4% (27/147) had AH at 1 week; among teeth with baseline AH this proportion was 47% (27/58). Pearson correlation coefficients between hypersensitivity while chewing and hypersensitivity while clenching at baseline and at 1 week were significant (0.64 and 0.71, respectively). Baseline or postoperative hypersensitivity was not correlated with either cavity depth or volume. Baseline AH was associated with active caries ranking (chi-square test: p <.05).

Conclusions: Appreciable hypersensitivity was present in ~31% of teeth with occlusal caries; this number was reduced ~53% by RBC restoration. Following RBC restoration, AH at 1 week was found in ~18% of teeth with no baseline AH. Baseline AH and active caries were positively correlated. Supported by NIDCR U01-DE016755.