Failure risk of posterior composites with post-operative sensitivity

Post-operative sensitivity (POS) may be observed in recently placed posterior composites. Evidence-based guidelines for the management of posterior composites with POS have yet to be determined. This study examined a retrospective analysis of the findings of a unique multi-center clinical trial to investigate the five-year risk of failure of posterior composites with POS and to determine the factors likely to have an important impact on the prognosis of the restorations. Longitudinal five-year data from the multi-center trial of Occlusin were analyzed. Data pertaining to a total of 1,101 restorations were included in the study. The failure rate at five years was calculated by means of three selected methods for all the restorations included in the study and for restorations with POS. Risk of failure for restorations with POS was analyzed by calculating an odds ratio along with the 95% confidence interval (CI). Logistic regression was carried out in order to identify those factors most likely to have had an important impact on the prognosis of restorations with POS. The analysis revealed that the restorations of Occlusin with POS were found to have been more likely to have failed at five years than the restorations of Occlusin without POS, with odds ratios ranging from 1.73 (95% CI: 1.04, 2.87) to 1.97 (95% CI: 1.36, 2.85). Distributions of patient age and cavity size were significantly different for successful and failed restorations (chi-square test, p < 0.05). Logistic regression indicated that cavity size was the only factor likely to have influenced the prognosis of the restorations with POS (p = 0.041, odds ratio 3.21, 95% CI 1.05: 9.70). Restorations with POS in large cavities were more likely to have failed by five years than restorations in small cavities. It was concluded that the restorations with Occlusin included in the Occlusin trial program were more likely to have failed at five years if POS occurred within one month of placement. Cavity size has been shown to have been an important factor in the prognosis of Occlusin trial restorations with POS.