Evaluation of postoperative sensitivity in restorations with self-adhesive resin: a randomized split-mouth design controlled study

  • Natália Gomes de Oliveira
  • Alessandra Souza Leão Costa Lima
  • Marina Torreão da Silveira
  • Pollyana Rodrigues de Souza Araújo
  • Gabriela Queiroz de Melo MonteiroEmail author
  • Marianne de Vasconcelos Carvalho
Original Article



To evaluate the postoperative sensitivity of restorations with self-adhesive resin composite (SAC) (Vertise Flow (VER)/Kerr) compared with conventional resin composite with self-etching adhesive (Filtek Z250 (Z250)/3M ESPE; Clearfil SE Bond (CSEB)/Kuraray).

Materials and methods

A randomized, controlled, double-blind, split-mouth, two-arm clinical trial was conducted. Twenty-seven volunteers with third molars indicated for extraction received two deep class I restorations, one with each material. Postoperative sensitivity was measured at 24 h and 15 or 30 days after the restorative procedures using a visual analog scale (VAS). When present, information on the characteristics of the pain was also collected. The data were submitted to the McNemar test (α = 0.05).


Regardless of the time intervals, the postoperative sensitivity was observed in 52% and 48% of the CSEB and VERT groups, respectively (p = 1.000). When the evaluation periods were analyzed, the 15-day evaluation presented the highest occurrence of pain, but of mild intensity, in both groups. All patients with sensitivity reported that the pain was localized and of short duration.


Self-adhesive resin composite Vertise Flow and conventional resin composite with a self-etching bonding agent promoted similar response regarding postoperative sensitivity in deep class I cavities. When postoperative sensitivity was present, mild pain was observed, especially after 15 days of the restorative procedure, which decreased over time.

Clinical relevance

Postoperative sensitivity to self-adhesive resin composite (SAC) restorations in deep cavities was comparable with that of conventional restorations with a self-etching bonding agent.


Postoperative sensitivity Randomized clinical trial Self-adhering composite Visual analog scale 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

784_2019_3046_MOESM1_ESM.pdf (106 kb)
ESM 1 (PDF 106 kb)


  1. 1.
    Ferracane JL (2011) Resin composite state of the art. Dent Mater 27:29–23CrossRefGoogle Scholar
  2. 2.
    Miyazaki M, Tsujimoto A, Tsubota K, Takamizawa T, Kurokawa H, Platt JA (2014) Important compositional characteristics in the clinical use of adhesive systems. J Oral Sci 56:1–9CrossRefGoogle Scholar
  3. 3.
    Rahimian-imam S, Ramazani N, Fayazi MR (2015) Marginal microleakage of conventional fissure sealants and self-adhering flowable composite as fissure sealant in permanent teeth. J Dent (Tehran) 12:430–435Google Scholar
  4. 4.
    Radovic I (2008) Self-adhesive resin cements: a literature review. J Adhes Dent 10:251–258Google Scholar
  5. 5.
    Maas MS, Alania Y, Natale LC, Rodrigues MC, Watts DC, Braga RR (2017) Trends in restorative composites research: what is in the future? Braz Oral Res 31:e55CrossRefGoogle Scholar
  6. 6.
    Shafiei F, Saadat M (2016) Micromorphology and bond strength evaluation of adhesive interface of a self-adhering flowable composite resin-dentin: effect of surface treatment. Microsc Res Tech 79:403–407CrossRefGoogle Scholar
  7. 7.
    Sachdeva P, Goswami M, Singh D (2016) Comparative evaluation of shear bond strength and nanoleakage of conventional and self-adhering flowable composites to primary teeth dentin. Contemp Clin Dent 7:32631Google Scholar
  8. 8.
    Celik EU, Kucukyilmaz E, Savas S (2015) Effect of different surface pre-treatment methods on the microleakage of two different self-adhesive composites in class V cavities. Eur J Paediatr Dent 16:33–38Google Scholar
  9. 9.
    Sabbagh J, Dagher S, El Osta N, Souhaid P (2017) Randomized clinical trial of a self-adhering flowable composite for class I restorations: 2-year results. Int J Dent 2017:5041529CrossRefGoogle Scholar
  10. 10.
    Berkowitz GS et al (2009) Postoperative hypersensitivity in class I resin-based composite restorations in general practice: interim results. Compend Contin Educ Dent 30:356–363Google Scholar
  11. 11.
    Davidovic L, Radovic I, Krunic J (2014) Prevention of postoperative sensitivity in composite restorations. Serbian Dent J 61:84–92CrossRefGoogle Scholar
  12. 12.
    Oz FD, Kutuk ZB, Ozturk C, Soleimani R, Gurgan S (2019) An 18-month clinical evaluation of three different universal adhesives used with a universal flowable composite resin in the restoration of non-carious cervical lesions. Clin Oral Investig 23:1443–1452CrossRefGoogle Scholar
  13. 13.
    Porto ICCM (2012) Post-operative sensitivity in direct resin composite restorations: clinical practice guidelines. IJRD 1:1–12 Available from: Google Scholar
  14. 14.
    Uneromi M et al (2001) Composite resin restoration and postoperative sensitivity: clinical follow-up in an undergraduate program. J Dent 29:7–13CrossRefGoogle Scholar
  15. 15.
    Casselli DSM, Martins LRM (2006) Postoperative sensitivity in class I composite resin restorations in vivo. J Adhes Dent 8:53–58Google Scholar
  16. 16.
    Reis A, Loguercio AD, Schroeder M, Luque-Martinez I, Masterson D, Maia LC (2015) Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations? A systematic review and metaanalysis. Dent Mater 31:1052–1067CrossRefGoogle Scholar
  17. 17.
    Yousaf A, Aman N, Manzoor MA, Shah JÁ, Dilrasheed (2014) Postoperative sensitivity of self etch versus total etch adhesive. J Coll Physicians Surg Pak 24:383–386Google Scholar
  18. 18.
    Moosavi H, Maleknejad F, Sharifi M, Ahrari F (2015) A randomized clinical trial of the effect of low-level laser therapy before composite placement on postoperative sensitivity in class V restorations. Lasers Med Sci 30:1245–1249CrossRefGoogle Scholar
  19. 19.
    Vichi A, Margvelashvili M, Goracci C, Papacchini F, Ferrari M (2013) Bonding and sealing ability of a new self-adhering flowable composite resin in class I restorations. Clin Oral Investig 17:1497–1506CrossRefGoogle Scholar
  20. 20.
    Wei YJ, Silikas N, Zhang ZT, Watts DC (2011) Hygroscopic dimensional changes of self-adhering and new resin-matrix composites during water sorption/desorption cycles. Dent Mater 27:259–266CrossRefGoogle Scholar
  21. 21.
    Çelik EU, Aka B, Yilmaz F (2015) Six-month clinical evaluation of a self-adhesive flowable composite in noncarious cervical lesions. J Adhes Dent 17:361–368Google Scholar
  22. 22.
    Kucukyilmaz E, Savas S (2015) Evaluation of different fissure sealant materials and flowable composites used as pit-and-fissure sealants: a 24-month clinical trial. Pediatric Dentistry. Pediatr Dent 37:468–473Google Scholar
  23. 23.
    Pinna R, Bortone A, Sotgiu G, Dore S, Usai P, Milia E (2015) Clinical evaluation of the efficacy of one self-adhesive composite in dental hypersensitivity. Clin Oral Investig 19:1663–1672CrossRefGoogle Scholar
  24. 24.
    Saba K, Maxood A, Abdullah S, Riaz A, Din SU (2018) Comparison of frequency of post operative sensitivity in amalgam restorations using copal varnish and dentin adhesive liner. J Ayub Med Coll Abbottabad 30:163–166Google Scholar
  25. 25.
    Hirani RT, Batra R, Kapoor S (2018) Comparative evaluation of postoperative sensitivity in bulk fill restoratives: a randomized controlled trial. J Int Soc Prev Community Dent 8:534–539CrossRefGoogle Scholar
  26. 26.
    Mjor IA (2009) Dentin permeability: the basis for understanding pulp reactions and adhesive technology. Braz Dent 20:316Google Scholar
  27. 27.
    Hickey D, Sharif O, Janjua F, Brunton PA (2016) Bulk dentine replacement versus incrementally placed resin composite: a randomized controlled clinical trial. J Dent 46:1822CrossRefGoogle Scholar
  28. 28.
    Skovlund E, Breivik H (2016) Analysis of pain-intensity measurements. Scand J Pain 13:123124CrossRefGoogle Scholar
  29. 29.
    Wang L, Magalhães AC, Francisconi-dos-Rios LF, Calabria MP, Araújo DFG, Buzalaf MAR, Pereira JC (2016) Treatment of dentin hypersensitivity using nano-hydroxyapatite pastes: a randomized three-month clinical trial. Oper Dent 41:93–101CrossRefGoogle Scholar
  30. 30.
    Ravishankar P, Viswanath V, Archana D, Keerthi V, Dhanapal S, Lavanya Priya KP (2018) The effect of three desensitizing agents on dentin hypersensitivity: a randomized, split-mouth clinical trial. Indian J Dent Res 29:51–55CrossRefGoogle Scholar
  31. 31.
    Yaylali IE, Kurnaz S, Tunca YM (2018) Maintaining apical patency does not increase postoperative pain in molars with necrotic pulp and apical periodontitis: a randomized controlled trial. J Endod 44:335–340CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Natália Gomes de Oliveira
    • 1
  • Alessandra Souza Leão Costa Lima
    • 1
  • Marina Torreão da Silveira
    • 1
  • Pollyana Rodrigues de Souza Araújo
    • 1
  • Gabriela Queiroz de Melo Monteiro
    • 1
    Email author
  • Marianne de Vasconcelos Carvalho
    • 1
  1. 1.School of DentistryUniversidade de Pernambuco–UPECamaragibeBrazil

Personalised recommendations