Evaluation of remineralizing effect of zinc-carbonate hydroxyapatite on the reduction of postrestorative sensitivity: A randomized controlled clinical trial

J Conserv Dent. 2023 Jan-Feb;26(1):56-66. doi: 10.4103/jcd.jcd_300_22. Epub 2022 Dec 8.

Abstract

Background: The adhesive bonding ability of composite resins makes it unnecessary to remove tooth structure for retention, prevention, and convenience. However, postoperative sensitivity after placing composite restoration has been a significant problem experienced by clinicians.

Aim: The present randomized controlled trial was conducted to assess the role of dentin remineralization in the reduction of postoperative sensitivity after composite placement.

Materials and methods: Eighty participants with occlusal carious teeth were randomly allocated to one of the four study groups, each having 20 participants, and are as follows: Group A with test group, Group A with control group, Group B with test group, and Group B with control group. Postoperative sensitivity was assessed using the Visual Analog Scale (VAS) and the United States Public Health Service (USPHS) criteria at different time intervals such as baseline, 1 week, 1 month, and 3 months. Data were analyzed using the Kruskal-Wallis ANOVA test, Mann-Whitney U-test, and Wilcoxon matched-pair test.

Results: All 80 participants were analyzed at the baseline, 1 week, 1 month, and the end of 3 months for the postoperative sensitivity using the VAS score and USPHS criteria. One restoration in Group A with control group reported mild sensitivity at the end of 1 week and one restoration in Group B with control group reported severe sensitivity at the end of 3 months, necessitating its replacement followed by root canal treatment. No relationship was reported between postoperative sensitivity and tooth type. There was no statistically significant difference in postoperative sensitivity in any of the treatment modalities.

Conclusion: Class I restoration using self-etch or selective-etch as well as with or without zinc-carbonate hydroxyapatite is a viable and predictable solution for the reduction of postoperative sensitivity if all the aspects of restorative techniques are considered precisely.

Keywords: Composite resin; postoperative sensitivity; remineralization; selective-etch; self-etch; zinc-carbonate hydroxyapatite.