Evaluation of postoperative sensitivity in restorations with self-adhesive resin: a randomized split-mouth design controlled study.

OBJECTIVES: To evaluate the postoperative sensitivity of restorations with self-adhesive resin composite (SAC) (Vertise Flow (VER)/Kerr) compared with conventional resin composite with self-etching adhesive (Filtek Z250 (Z250)/3M ESPE; Clearfil SE Bond (CSEB)/Kuraray). MATERIALS AND METHODS: A randomized, controlled, double-blind, split-mouth, two-arm clinical trial was conducted. Twenty-seven volunteers with third molars indicated for extraction received two deep class I restorations, one with each material. Postoperative sensitivity was measured at 24 h and 15 or 30 days after the restorative procedures using a visual analog scale (VAS). When present, information on the characteristics of the pain was also collected. The data were submitted to the McNemar test (α = 0.05). RESULTS: Regardless of the time intervals, the postoperative sensitivity was observed in 52% and 48% of the CSEB and VERT groups, respectively (p = 1.000). When the evaluation periods were analyzed, the 15-day evaluation presented the highest occurrence of pain, but of mild intensity, in both groups. All patients with sensitivity reported that the pain was localized and of short duration. CONCLUSION: Self-adhesive resin composite Vertise Flow and conventional resin composite with a self-etching bonding agent promoted similar response regarding postoperative sensitivity in deep class I cavities. When postoperative sensitivity was present, mild pain was observed, especially after 15 days of the restorative procedure, which decreased over time. CLINICAL RELEVANCE: Postoperative sensitivity to self-adhesive resin composite (SAC) restorations in deep cavities was comparable with that of conventional restorations with a self-etching bonding agent.

Treatment of an Acute Apical Abscess in a Patient With Autoimmune Hepatitis Taking Alendronate: A Case Report.

INTRODUCTION: The aim of this study was to report a patient's clinical case who was diagnosed with severe apical abscess and with autoimmune hepatitis (AIH) using immunosuppressive drugs and bisphosphonate. METHODS: A 32-year-old man of black African descent urgently sought dental surgery because of an increase in volume in the right genic region and a nuisance in the region of the lower right second premolar when chewing. After intraoral and radiographic clinical examination, the patient was diagnosed with pulp necrosis and an acute apical abscess. Because he had AIH and was taking corticosteroids and bisphosphonate (alendronate), he was submitted to endodontic therapy as a minimally invasive treatment, considering his systemic state. RESULTS: After 3 years of follow-up treatment with periapical and tomographic radiographic control, bone repair of the periapical region of the tooth was observed. CONCLUSIONS: Through this report, we can infer that it is possible to reverse the condition of a periapical lesion in a tooth with an acute apical abscess and necrotic pulp in an AIH patient who is using alendronate without the need for more invasive procedures and that would put at risk the patient's general and oral condition in the postoperative period.