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CHIRURGIE OROMAXILOFACIALÅ
POSTOPERATIVE SENSITIVITY: A COMPARI-
SON OF TWO BONDING AGENTS
William D Browning 1, DDS, MS; John S Blalock 2, DMD; Rick S Callan 3,
DMD; William W Brackett 4 , DDS, MsD; G Franklin Schull 5 , DMD;
Michael B Davenport 6, DMD; Martha G Brackett 7, DDS, MsD,
1 Professor and director of Clinical Research, Department of Oral Rehabilitation,
School of Dentistry, Medical College of Georgia, Augusta, GA, USA
2 Assistant professor, Department of Oral Rehabilitation, School of Dentistry,
Medical College of Georgia, Augusta, GA, USA
3 Assistant professor, Department of Oral Rehabilitation, School of Dentistry,
Medical College of Georgia, Augusta, GA, USA
4Associate professor, Department of Oral Rehabilitation, School of Dentistry,
Medical
College of Georgia, Augusta, GA, USA
5 Clinical instructor, Department of Oral Rehabilitation, School of Dentistry, Medical
College of Georgia, Augusta, GA, USA
6Clinical instructor, Department of Oral Rehabilitation, School of Dentistry, Medical
College of Georgia, Augusta, GA, USA
7Instructor, Department of Oral Rehabilitation, School of Dentistry, Medical College
of Georgia, Augusta, GA, USA
ABSTRACT
Historically, postoperative pain associated with temperature was considered a thermal conduction problem. More recently, pulpal
hydrodynamics has been used to explain this sensitivity. Relative to restorations placed with dentin bonding agents that require a
separate etching step, agents that include an acidic primer are believed to result in a better seal of the dentinal tubules. This study
compared pain associated with a standardized cold stimulus in two groups of restorations. One group was placed with a selfpriming
resin that required a separate etch step, the other with a self-etching, self-priming dentin bonding agent.
This was a community-based, randomized, double-blind clinical trial. Two hundred and nine restorations were placed for 76
participants. All teeth were asymptomatic at the start of the trial. Immediately following application of a standardized cold stimulus,
participants rated the pain for each restored tooth using a Visual Analog Scale (VAS). For each group of restorations, VAS scores
at 13 weeks were compared to preoperative scores. In addition, the preoperative score was subtracted from the 13-week score,
and the two groups of restorations were compared.
For both groups of restorations, the median scores were significantly reduced at 13 weeks. This decrease in the VAS score
reflects a reduction in sensitivity below that which existed preoperatively. There was no significant difference between the two
groups of restorations in terms of change in sensitivity at 13 weeks.
Key words: postoperativ paine, seal of the dentinal tubules, dentin bonding agent
REZUMAT
În trecut durerea postoperatorie asociatå cu temperaturå a fost consideratå rezultatul unor probleme ce ¡ine de conducerea
termicå. Studii mai recente, au eviden¡iat cå aceastå sensibilitate poate fi aplicatå prin mecanismele hidrodinamice la nivel pulpar.
Restaurårile care impun condi¡ionarea dentinei într-o etapå suplimentarå cu un primer determinå o mai bunå sigilare a canaliculelor
dentinare. Acest studiu a analizat durerea apårutå la stimului reci, subiec¡ii fiind împår¡i¡i în douå grupuri. La primul grup s-a utilizat
o rå¿inå autopolimerizabilå care necesitå o etapå suplimentarå pentru adeziune, iar la celålalt grup un adeziv dentinar
autopolimerizabil.
Acest studiu clinic a fost la nivelul comunitå¡i¡ii, subiec¡ii fiind ale¿i aleatoriu. Au fost realizate 209 restaura¡ii la 76 de participan¡i. To¡i
din¡ii erau asimptomatici la începutul studiului. Imediat dupå aplicarea stimulilor standard reci, participan¡ii au clasificat durerea
pentru fiecare dinte conform scårii (graficului) Vizual Analogic(VAS). Pentru fiecare grup de restaura¡ii, rezultatele VAS ob¡inute la
13 såtåmâni au fost comparate cu scorurile preoperatorii, putându-se astfel realiza o compara¡ie între cele 2 grupuri.pentru
ambele grupuri de restaura¡ii, valorile medii erau mai reduse la 13 såptåmâni. Aceastå scådere a scorurilor VAS eviden¡ieazå o
diminuare a sensibilitå¡ii comparativ cu rezultatele ini¡iale, preoperatorii. Nu a existat o diferen¡å semnificativå între cele 2 grupuri,
în ceea ce prive¿te gradul de sensibiliate analizat la 13 såptåmâni.
Cuvinte cheie: durere postoperatorie, sigilarea canaliculelor dentinare, adeziv dentinar.
REVISTA ROMÂNÅ DE STOMATOLOGIE – VOL. LIII, NR. 2, AN 2007 75
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