Postoperative Sensitivity When Using Bulk-fill Composites With Surface Sealant

Objectives: The objective of this double-blind randomized clinical trial was to compare the postoperative sensitivity (POS) until 7 days after posterior restorations performed with a bulk-fill composite (Tetric N-Ceram Bulk Fill, Ivoclar Vivadent) covered or not with a surface sealant (Biscover LV, Bisco or PermaSeal, Ultradent)
Methods: A total of 174 restorations were placed in 57 patients (male=29.8%; female=70.2%), aged ranged 20-69 years (mean age=41.68 ± 11.77), according to the following groups: NSS– No surface sealant (n=60); BC– Biscover (n=59) and; PS– PermaSeal (n=55). Tetric N-Ceram Bulk Fill was placed using Bulk-fill technique. The adhesive system (Tetric N-Bond, Ivoclar Vivadent) was used according to manufacturer’s instructions in the self-etching strategy. The postoperative sensitivity was evaluated over a period of 7 days through two scales (NRS and VAS) Considering that the same patient may receive several restorations, statistical analysis was performed using a generalized estimating equation model (GEE), avoiding that cluster effect (p<0.05)
Results: During the first 24 hours there were 10 (5.7%) cases of stimulated POS in 7 different patients (VAS scale = 4 mild, 5 moderate and 1 considerable; NRS scale = 10 mild). At 48 hours, 8 (4.6%) restorations remained with POS (VAS scale = 4 mild and 4 moderate; NRS scale = 8 mild) and after 72 hours no cases of POS were recorded. The overall risk of POS was 0.57 (CI=0.32–1.03). Among 10 cases of POS, 7.8% (2/60) was reported for no cover vs. 5.1% (3/59) Biscover and 9.1% (5/55) PermaSeal surface sealed restorations groups. In GEE analysis (Wald Chi-Square) no statistical difference in the postoperative sensitivity was found between no sealed surfaces and Biscover (OR=1.55; CI=0.26-9.43; p=0.63) or PermaSeal (OR=2.9; CI=0.48-17.52; p=0.25) sealed restorations.
Conclusions: The application of a surface sealant did not affect the occurrence of spontaneous postoperative-sensitivity in bulk-fill restorations