Postoperative Sensitivity of Composite Replacement of Amalgam Restoration: A Randomized Clinical Trial

Purpose: This randomized clinical trial aimed to evaluate the postoperative sensitivity of different resin composite/adhesive materials, placed either by an incremental or bulk-fill technique in posterior resin composite replacement of amalgam restorations. Methods and Materials: A total of 47 patients with good overall health and at least four class I or class II amalgam restorations to be replaced participated in this study. The characteristics of 188 cavities were registered and randomly restored using incremental (Z350XT, 3M) or bulk-fill (Filtek Bulk Fill, 3M; Sonic Fill, Kerr; and Opus Bulk Fill, FGM) technique. The postoperative sensitivity was assessed using a Visual Analog Scale (0-100) after 24 hours, 7 days, and 30 days. Pain scores were temporally analyzed using Friedman test followed by Dunn post hoc test (alpha=0.05). The frequency of tests was calculated according to the frequency and percentage of the McNemar test. Results: The restorative technique and the bulkfill system used did not affect the postoperative sensitivity, except for Filtek Bulk Fill group, which presented less postoperative sensitivity after 24 hours (p=0.037). Regardless of the restorative material, the postoperative sensitivity decreased after 24 hours, and no differences were found after 7 and 30 days. Conclusions: After 1 week, the filling technique and the bulk-fill system have no influence on the postoperative sensitivity.