Sensitivity After Cavity Lining Or Etching And Sealing In Practice

Objectives: We tested the hypothesis that etching, priming and sealing (E) cavities is no less effective in preventing postoperative sensitivity than traditional lining (L) with calcium hydroxide cement. Methods: Five hundred and seventy nine vital posterior teeth requiring an occlusal or proximal restoration were recruited from consecutive consenting patients in five general practices. Before cavity preparation, teeth were randomly allocated for L or E. Choice of bulk restorative material, amalgam (A) or composite (C), was at the discretion of the dentist. Patients recorded postoperative sensitivity at 24h, 4d and 7d on 100mm visual analogue scales (0=no sensitivity, 100=unbearable sensitivity). 362 amalgams (182L,177E) and 217 composites (92L,125E) were placed.Results:There was no significant difference amongst the mean sensitivity scores of any restorative combination at any given postoprative period. Mean sensitivity diminished with time for all combinations of cavity treatment and bulk restorative material. At 24h, the probability of a visual analogue score >50mm was 6.3% for L and 5.1% for E (p=0.182). The probability of recording a score >50mm was 7.8% for A and 3.6% for C (p=0.258). Regardless of threshold set, there was no significant difference in the likelihood of postoperative sensitivity for L or E teeth. Teeth restored with A were significantly more likely to yield sensitivity scores >80mm than those restored with C (p=0.021). Conclusions: There is no significant difference in early postoperative discomfort experienced by patients whose cavities were E or L. Primary care dentists can be confident that patients will not suffer increased postoperative sensitivity after cavity sealing with adhesive resins. Funded by UK NHS Primary Dental Care R&D scheme.