Resinas bulk fill vs resinas convencionais na sensibilidade pós-operatória: uma revisão sistemática com meta-análise

Abstract

Objective: To compare restorations performed with bulk fill resins vs. conventional resins in relation to postoperative sensitivity, through a systematic review of randomized clinical studies (RCT). Sources: Five electronic databases were searched: Pubmed, Cochrane, Web of science, Scopus and Open gray. Study selection: RCTs that compared the postoperative sensitivity observed in teeth restored with conventional resins vs bulk fill resins were included. Studies that used cavity and / or desensitizing liners were excluded from the study. The risk of bias was classified by the Cochrane guidelines. Two meta-analyzes were performed to assess the postoperative sensitivity of restorations made with bulk fill and conventional resin in the periods of 7 and 180 days. Results: Five RCTs with a low risk of bias were included in the meta-analysis. The evaluation after 7 days was performed in Non-Carious Cervical Injury and in Black classes I and II. Patients who used Bulk fill resins (n = 143) had lower postoperative sensitivity when compared to the use of conventional composite resin (n = 142) (-0.06 [-0.11, -0.01], p = 0.03). The second evaluation, after 180 days, was performed in class V cavities. There was no significant difference in postoperative sensitivity between patients who used Bulk fill resins (n = 125) compared to the use of conventional composite resin (n = 121) in the 180-day period (-0.02 [-0.11, 0.08], p = 0.73). Conclusions: Restorations with bulk fill resins showed lower postoperative sensitivity when compared to restorations using conventional resins up to seven days after restoration and there was no difference in postoperative sensitivity in the 180-day evaluation. However, due to the relatively limited amount of evidence to support this conclusion, more RCTs with a low risk of bias should be performed. Clinical significance: Postoperative sensitivity is very recurrent after restorative treatment, which has led to the development of new materials to circumvent this complication. The restorative treatment using bulk fill resins had a positive effect on postoperative sensitivity when compared to conventional resins within 7 days.