Do self-etch adhesives cause less postoperative sensitivity than etch-and-rinse adhesives?
This summary is based on the critical appraisal published in the Journal of Esthetic and Restorative Dentistry: Post-op Sensitivity with Direct Composite Restorations (August 2013)
Total-etch versus Self-etch Adhesive: Effect on Postoperative Sensitivity. Journal of the American Dental Association 2003 (134:1621–9)
Postoperative Sensitivity in Class I Composite Resin Restorations in Vivo. Journal of Adhesive Dentistry 2006 (8:53–8)
Clinical Evaluation of a Two-step Etch & Rinse and a Two-step Self-etch Adhesive System in Class II Restorations:Two-year Results. Operative Dentistry 2009 (39:656–63)
Effect of Glass-ionomer Cement Lining on Postoperative Sensitivity in Occlusal Cavities Restored with Resin Composite—A Randomized Clinical Trial. Operative Dentistry 2009 (34:648–55)
- Much anecdotal evidence indicates that postoperative sensitivity is reduced when self-etch adhesives are used to place posterior composite restorations than when etch-and-rinse adhesives are used.
- The results of controlled clinical trials do not support this anecdotal evidence. Postoperative sensitivity in clinical trials is similar for etch-and-rinse and self-etch adhesives.
- In some clinical studies, all restorations were placed by a single operator. In most, rubber dam isolation was used. Thus, “real world” results might be different from those obtained under relatively ideal conditions in clinical trials.
- The clinical trials show that operator technique is a more important factor than choice of the adhesive system in postoperative sensitivity.
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