title: Postoperative hypersensitivity and its relationship to preparation variables in Class I resin-based composite restorations: findings from the practitioners engaged in applied research and learning (PEARL) Network. Part 1.
abstract: BACKGROUND
  This study investigated postoperative hypersensitivity at 1, 4, and 13 weeks following resin-based composite (RBC) restorations of occlusal caries and its relationship with prepreparation (baseline) sensitivity and preparation-related variables, including dentin caries activity, cavity dimension and volume, and lesion radiographic visibility.
  
  
  METHODS
  Investigators in a practice-based research network enrolled patients with occlusal caries deemed to require operative treatment. The 45 dental practitioners then placed restorations using their preferred techniques. Complete baseline data on 665 restorations from 602 patients included patient-reported sensitivity (pre-preparation); dentists' ranking of dentin caries on opening the enamel; measurements of preparation depth, width, and length; and patient demographics. At 1, 4, and 13 weeks post-treatment, patients anonymously reported any sensitivity to hot and cold stimuli, sweets, clenching, and chewing, as well as quality-of-life indicators related to the restorations.
  
  
  RESULTS
  At baseline, 30% of teeth had reported sensitivities of ≥3 on an anchored scale from 0 to 10 points and were designated as appreciable hypersensitivity (AH). Appreciable hypersensitivity at baseline was related to lesion radiographic visibility and patient age but not to dentin caries activity ranking, type of posterior tooth, gender, or race/ethnicity. Patients reported on 491 restorations at 4 weeks post-treatment--18% had AH. Of those who had AH, 39% (34 of 87) had no baseline AH. With restoration, 63% of teeth with baseline AH no longer had AH. Changes in AH were not associated with preparation depth, length, width, or volume.
  
  
  CONCLUSIONS
  Patient-reported occlusal caries tooth sensitivity was high at baseline and eliminated by RBC restoration in 63% of cases; however, new sensitivity after restoration was reported in 10% of lesions that had none at pretreatment. Sensitivity was not related to preparation dimensions, volume, tooth type, or patient demographics (other than age) in these early lesions.
authors: Department of Cariology and Comprehensive Care, New York University College of Dentistry, New York, New York, USA.
authors: Gary
authors: G
authors: Berkowitz
authors: Howard
authors: H
authors: Spielman
authors: Abigail
authors: A
authors: Matthews
authors: Donald
authors: D
authors: Vena
authors: Ronald
authors: R
authors: Craig
authors: Frederick
authors: F
authors: Curro
authors: Van
authors: V
authors: Thompson
mesh_terms: D000328:Adult; D000367:Age Factors; D055812:Community-Based Participatory Research; D003731:Dental Caries / Q000473:pathology / Q000628:therapy; D003736:Dental Cavity Lining / Q000009:adverse effects; D003737:Dental Cavity Preparation / Q000009:adverse effects*; D003793:Dental Restoration, Permanent / Q000009:adverse effects* / Q000379:methods; D003804:Dentin / Q000473:pathology; D003807:Dentin Sensitivity / Q000209:etiology*; D017220:Dentin-Bonding Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D017220:Dentin-Bonding Agents
references: Oper Dent. 2002 Nov-Dec;27(6):543-8
references: 12413217
references: J Clin Periodontol. 2010 Nov;37(11):968-72
references: 20880054
references: Compend Contin Educ Dent. 2009 Jul-Aug;30(6):352-4
references: 19715012
references: J Adhes Dent. 2009 Apr;11(2):149-59
references: 19492717
references: Community Dent Health. 1994 Mar;11(1):3-11
references: 8193981
references: Int J Oral Maxillofac Surg. 2003 Jun;32(3):334-6
references: 12767883
references: N Y State Dent J. 2007 Mar;73(2):23-9
references: 17472181
references: Compend Contin Educ Dent. 2009 Jul-Aug;30(6):356-8, 360, 362-3
references: 19715013
references: Eur J Dent Educ. 2011 Nov;15 Suppl 1:23-31
references: 22023543
references: Am J Dent. 2006 Jun;19(3):151-4
references: 16838478
references: Am J Dent. 2004 Jun;17(3):191-5
references: 15301216
references: Oper Dent. 2009 Nov-Dec;34(6):648-55
references: 19953773
references: Oper Dent. 2002 May-Jun;27(3):297-304
references: 12022463
references: Acta Odontol Scand. 2003 Aug;61(4):235-40
references: 14582592
references: Am J Dent. 2001 Feb;14(1):34-8
references: 11806478
references: J Am Dent Assoc. 2003 Dec;134(12):1581-9
references: 14719754
references: Dent Mater. 2008 Jan;24(1):1-8
references: 17920115
references: J Dent Res. 1991 Jun;70(6):975-8
references: 2045578
references: J Am Dent Assoc. 2012 Apr;143(4):377-85
references: 22467698
references: Clin Oral Investig. 2001 Sep;5(3):148-55
references: 11642558
references: Am J Dent. 2008 Jun;21(3):148-52
references: 18686764
references: Oper Dent. 2007 Mar-Apr;32(2):112-7
references: 17427818
references: Quintessence Int. 2005 May;36(5):365-72
references: 15892534
references: J Am Dent Assoc. 2002 Feb;133(2):229-31
references: 11868844
references: J Adhes Dent. 2006 Apr;8(2):119-26
references: 16708724
references: J Oral Rehabil. 2005 Sep;32(9):661-8
references: 16102079
references: J Adhes Dent. 2009 Apr;11(2):137-41
references: 19492715
references: Clin Oral Investig. 2003 Mar;7(1):20-6
references: 12673433
references: Oper Dent. 2009 Jan-Feb;34(1):3-10
references: 19192831
references: Oper Dent. 2007 Sep-Oct;32(5):421-6
references: 17910217
references: J Oral Rehabil. 2010 Jul;37(7):532-7
references: 20202097
references: Am J Dent. 1998 Oct;11(5):229-34
references: 10388382
references: Oper Dent. 1996 Jan-Feb;21(1):17-24
references: 8957911
references: J Esthet Restor Dent. 2001;13(1):50-7
references: 11831309
references: Caries Res. 2003 Mar-Apr;37(2):125-9
references: 12652050
references: Am J Dent. 2007 Apr;20(2):125-33
references: 17542208
references: Eur J Oral Sci. 2003 Jun;111(3):243-52
references: 12786956
references: Dent Mater. 2009 Mar;25(3):314-20
references: 18762335
references: Community Dent Health. 2004 Dec;21(4):306-11
references: 15617416