Clinical evaluation of two adhesive composite cements for the suppression of dentinal cold sensitivity.
BACKGROUND
Postoperative cold sensitivity after the cementation of indirect restorations with composite cements has been reported frequently but not scientifically documented.


OBJECTIVE
This controlled clinical study was designed to simulate the dentin/composite cement interface immediately after cementation of a cast restoration. The desensitizing capabilities of a composite cement that contains a self-etching, dual-polymerizing resin adhesive system were compared with those of a composite cement that use phosphoric acid etching followed by a single-bottle, light-activated primer/resin-based adhesive.


METHODS
The hypersensitive root surfaces of selected teeth were randomized to receive 1 of 3 treatments: coating with a self-etching adhesive (Linkmax) and its respective cement, coating with a conventionally etched adhesive (RelyX ARC) and its cement, or no treatment (negative control). The sample size was 22. Dentin sensitivity was ascertained with an accurate cold testing device that slowly decreased in temperature. Tooth sensitivity was measured both immediately and at 7 days after placement. Two-way analysis of variance and Fisher's least significant difference test (P<.05) were used to determine whether significant differences existed as a function of treatment type or time.


RESULTS
Immediately after placement, the self-etching adhesive and its respective cement resulted in more suppression of cold sensitivity than no treatment (control); with Linkmax treatment, the temperature at which teeth responded was reduced by 8.4 degrees C. The conventionally etched adhesive and its cement reduced the temperature at which teeth responded by 9.4 degrees C. After 1 week, these temperature reductions were 7.0 degrees C and 4.3 degrees C, respectively. Untreated controls at the 2 intervals showed a mean decrease in sensitivity to cold of 3.6 degrees C and 4.1 degrees C. Statistical analysis showed type of composite cement to be a significant factor.


CONCLUSIONS
Within the limitations of this study and in comparison to untreated control teeth, Linkmax treatment resulted in a significant reduction in tooth root sensitivity over 1 week (P=.02), whereas RelyX ARC did not (P=.066).
Sensat
Michelle L
ML
College of Dentistry, University of Nebraska Medical Center, Lincoln, NE 68583, USA. msensat@unmc.edu
Brackett
William W
WW
Meinberg
Trudy A
TA
Beatty
Mark W
MW
D000134:Acid Etching, Dental / Q000379:methods; D000328:Adult; D000704:Analysis of Variance; D017438:Bisphenol A-Glycidyl Methacrylate / Q000627:therapeutic use; D003080:Cold Temperature / Q000009:adverse effects; D003188:Composite Resins / Q000627:therapeutic use*; D003807:Dentin Sensitivity / Q000517:prevention & control*; D017220:Dentin-Bonding Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D010756:Phosphoric Acids / Q000008:administration & dosage; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011109:Polymethacrylic Acids / Q000627:therapeutic use; D019279:Resin Cements / Q000627:therapeutic use*; D013223:Statistics as Topic
D003188:Composite Resins; D017220:Dentin-Bonding Agents; C470486:Linkmax; D010756:Phosphoric Acids; D011109:Polymethacrylic Acids; C462240:RelyX ARC; D019279:Resin Cements; C115612:single bond; D011092:Polyethylene Glycols; D017438:Bisphenol A-Glycidyl Methacrylate; C030242:phosphoric acid