Adhesive Strategy and Post-operative Sensitivity: Systematic Review and Meta-analysis

Objectives: A systematic review and meta-analysis were performed on the risk and intensity of postoperative sensitivity (POS) in posterior restorations bonded with self-etch (SE) and etch-and-rinse (ER) adhesives.
Methods: Source. A comprehensive search was performed in the MEDLINE via PubMeb, Scopus, Web of Science, LILACS, BBO and Cochrane Library and SIGLE without restrictions. The abstracts of the annual conference of the IADR (1990–2014), unpublished and ongoing trials registry were also searched. Dissertations and theses were searched using the ProQuest Dissertations and Periodicos Capes Theses databases.
Study selection. We included randomized clinical trials that compared the clinical effectiveness of SE and ER used for direct composite resin restorations in permanent dentition of adult patients. The risk/intensity of POS was the primary outcome. The risk of bias tool of the Cochrane Collaboration was used. The meta-analysis was performed on the studies considered ‘low’ risk of bias.
Results: After duplicates removal, 2600 articles were identified but only 29 remained in the qualitative synthesis. Five were considered to be ‘high’ risk of bias and eleven were considered to be ‘unclear’ in the key domains, yielding 13 studies for meta-analysis. The overall relative risk was 0.85 (95% CI 0.59 – 1.22) while the overall standardized mean difference was 0.08 (95%CI -0.19 – 0.35). Both the risk (p = 0.38) and the intensity of POS (p = 0.55) were not influenced by the adhesive strategy.
Conclusions: The type of adhesive strategy for posterior composite restoration does not influence the risk and intensity of POS. CRD42014006617.