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Do self-etch adhesives cause less postoperative sensitivity than etch-and-rinse adhesives?

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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)

Studies Reviewed

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)

Key Messages

  • 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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2 Comments

  1. Reza Nouri October 22, 2013

    Using ideal conditions and proper isolation is paramount to the success of direct resin composite restorations, regardless of the bonding technique used. The factors that affect postoperative sensitivity are many and cannot be summarized in this post. What I hope most of our colleagues take from this type of research is the fact that resin composites are very technique sensitive materials and need a clean field for their success. They are not the magic bullet and proper material of choice for ALL types of restorations and conditions.

    Reply
  2. alex galo October 29, 2013

    I have been using Easy Bond from 3M for about the past 2 years. In my hands, I get WAY fewer instances of post operative sensitivity with it than I used to get when I did separate etching and bonding. I also never use any liner. So personally, I totally disagree with the JERD paper.

    Reply

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