Long-term follow-up of composite resin restorations with self-etching adhesives.
OBJECTIVE
To test the hypothesis, derived from a previous short-term (7-day) assessment, that the absence of conventional pulp protection is not responsible for long-term pulp complications of composite resin restorations with self-etching adhesives.


METHODS
All 150 patients who received the restorations with self-etching adhesives were recalled at least 2 years after the placement of restorations. Of the 47 patients (31%) who responded, 106 restorations aged from 2.2 to 6.5 years were examined for tooth sensitivity and pulp vitality regarding long-term pulp complications. The results were subjected to a multivariable logistic regression analysis with regard to cavity depth, provision of conventional pulp protection and short-term pulp complications.


RESULTS
No positive cases were found in the assessment of tooth sensitivity. Four restorations (3.7%) made in deep cavities with conventional pulp protection resulted in pulpectomy due to inflammation, of which three cases presented short-term pulp complications. The 95% confidence intervals for the odds ratios estimated by the multivariable logistic regression analysis were (1.54, infinity) for cavity depth (1.50, infinity) for short-term pulp complications and (0.02, infinity) for conventional pulp protection. Namely, the last variable had no significant effect on long-term pulp complications and thus the hypothesis was verified.


CONCLUSIONS
The absence of conventional pulp protection was not responsible for long-term pulp complications even in deep cavities with the use of self-etching adhesives. A deep cavity and the existence of short-term pulp complications were two critical predictors for the occurrence of long-term pulp complications.
Unemori
Masako
M
Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. unemori@dent.kyushu-u.ac.jp
Matsuya
Yoko
Y
Hyakutake
Hiroto
H
Matsuya
Shigeki
S
Goto
Yasuharu
Y
Akamine
Akifumi
A
D000134:Acid Etching, Dental; D000328:Adult; D000368:Aged; D003188:Composite Resins / Q000737:chemistry; D003737:Dental Cavity Preparation / Q000145:classification; D003782:Dental Pulp / Q000503:physiopathology; D003785:Dental Pulp Capping; D003793:Dental Restoration, Permanent; D003807:Dentin Sensitivity / Q000209:etiology; D017220:Dentin-Bonding Agents / Q000009:adverse effects / Q000737:chemistry; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011670:Pulpectomy; D011671:Pulpitis / Q000209:etiology; D014098:Toothache / Q000209:etiology
D003188:Composite Resins; D017220:Dentin-Bonding Agents