Comparative Evaluation of Post-operative Sensitivity between Light-Cure and Dual-Cure Composites in Open and Closed Sandwich Bilayer Restorations
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Abstract
Background: Post-operative sensitivity is a major worry after composite restorations because of polymerization shrinkage stress at the dentin–resin interface. Both open and closed sandwich techniques and different composite curing modes have been proposed to contain these effects. However, there are limited direct clinical comparisons between light-cure and dual-cure composites in these configurations. Objective: This study aimed to compare posterior composite restorations as dentin substitutes within open and closed sandwich techniques using light-cure and dual-cure composites and to assess post-operative sensitivity. Materials and Methods: A total of 67 patients were involved in this randomized double-blind clinical trial, contributing 205 posterior teeth. The teeth were
divided into four groups based on the technique used: Light-cure or dual-cure composite placed with either an open or closed sandwich technique. Post-operative sensitivity was evaluated subjectively and objectively using
cold testing at baseline and at 1, 3, 6, 9, and 12 months post-restoration. The data were analyzed using Chi-square
and Fisher’s exact tests. The level of significance was kept at P < 0.05. Results: All groups showed a significant
reduction in sensitivity from baseline to the first follow-up. At 12 months, the light-cure composite in the closed
sandwich group demonstrated slightly better outcomes (82.4% sensitivity-free) than the open sandwich group
(76.5%). For dual-cure composites, the open sandwich group was marginally better at 72.2% than the closed
group at 66.7%. However, none of these differences was statistically significant (P > 0.05). Conclusion: Both the
composite types and techniques gave low post-operative sensitivity for over 12 months. Slight trends favor the
light-cure composites in closed techniques and the dual-cure composites in open techniques. This would provide
clinical flexibility, especially when supported by strict operative protocols.
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