Influencing post-operative sensitivity after posterior composite restorations: a scoping review

OBJECTIVE: This scoping review aims to map and evaluate intra-operative factors influencing post-operative sensitivity (POS) in posterior composite restorations.

METHODOLOGY: Following the PRISMA-ScR and Arksey & O’Malley frameworks, five databases were searched until June 2024. Fifty- five clinical studies were included after screening 506 records.

RESULTS: POS was influenced by various factors including adhesive strategy, cavity depth, liners, desensitizers, and filling techniques. Most studies found no significant difference in POS between self-etch and etch-and-rinse adhesives. Incremental techniques, selective desensitizers (e.g., Gluma), and adjuncts like nanobioglass were effective in reducing sensitivity. However, bulkfill techniques and composite formulations had comparable outcomes. Depth of cavity consistently correlated with increased sensitivity, while a specific study showed reduction in sensitivity after laser pretreatment.

CONCLUSIONS: POS is multifactorial, impacted by both clinical and patient-related variables. This Scoping review included 55 studies identifying various procedures for reducing POS.
Tailoring restorative protocols and standardizing assessment methods may help to reduce incidence and improve outcomes in posterior composite restorations. No single factor showed a consistent impact on POS, despite individual studies reporting favourable results with particular materials or pretreatments.

CLINICAL SIGNIFICANCE: To improve the long-term outcome and prognosis of restoration it is important to obtain experience in reducing post operative sensitivity by different techniques.

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