Incidence and Determinants of Postoperative Sensitivity Following Class I and II Composite Restorations: A Prospective Clinical Study

Abstract

Background: Postoperative dental sensitivity following composite resin restorations is a common complication that may negatively affect patient comfort and satisfaction. Despite advances in adhesive systems and restorative techniques, the incidence, severity, and contributing clinical factors associated with postoperative sensitivity remain incompletely understood. This study aimed to evaluate the incidence and severity of postoperative sensitivity after Class I and II composite restorations and to investigate its association with clinical variables including cavity depth, restoration class, adhesive type, insertion technique, and curing protocol.

Materials and Methods: A one-year prospective clinical study was conducted in 2024 at the Dental Learning Center in Sirt. A total of 218 patients aged 18–60 years requiring Class I or II posterior composite restorations were included. Restorations were performed according to standardized clinical protocols by calibrated operators. Postoperative sensitivity was assessed at 24 hours, 7 days, and 30 days using a Patient Sensitivity Follow-up Questionnaire that evaluated sensitivity type, Visual Analogue Scale (VAS 0–10) scores, and impact on daily activities. Patients were permitted to report more than one sensitivity trigger. Statistical analysis was performed using Chi-square and ANOVA tests with SPSS version 26.

Results: At 24 hours, 72 patients (33%) reported postoperative sensitivity, with cold stimuli (56%) and biting or chewing pressure (35%) being the most common triggers among symptomatic patients. Sensitivity decreased to 34 patients (16%) after 7 days and to 9 patients (4%) after 30 days. Mean VAS scores decreased from 4.2 ± 1.8 at 24 hours to 0.7 ± 0.9 at 30 days. Class II restorations and deeper cavities were significantly associated with greater sensitivity severity and incidence (p < 0.05), whereas adhesive type, insertion technique, and curing protocol showed no statistically significant associations. Among symptomatic patients, interference with eating was reported by 85% at 24 hours, decreasing substantially during follow-up.

Conclusion: Postoperative sensitivity following composite restorations was generally temporary and self-limiting, with most symptoms resolving within 30 days. Larger and deeper restorations, particularly Class II restorations, were more susceptible to postoperative sensitivity. Careful operative technique and appropriate patient counseling remain important for minimizing postoperative discomfort. Further multicenter studies with longer follow-up periods are recommended to better clarify factors influencing postoperative sensitivity and optimize restorative outcomes.