THE EFFECTIVENESS OF BIOACTIVE GLASS FILLINGS IN REDUCING TOOTH SENSITIVITY IN RESTORED TEETH
Keywords:
bioactive glass; dentin hypersensitivity; postoperative sensitivity; restorative dentistry; randomized controlled trial; ion release; tubule occlusion; resin–dentine interface; Visual Analog Scale (VAS); Schiff sensitivity score; Khyber Pakhtunkhwa; Pakistan.Abstract
Background: Post-restoration tooth sensitivity remains a common reason for patient dissatisfaction and unplanned revisits after direct restorative treatment. Bioactive glass–based restorative technologies may reduce sensitivity by promoting ion release, mineral precipitation, and dentinal tubule occlusion, potentially improving comfort beyond what is achieved with conventional fillings.
Objective: To evaluate whether bioactive glass fillings reduce post-treatment tooth sensitivity more effectively than traditional dental fillings, with emphasis on sustained (long-term) outcomes.
Study Type: Randomized controlled trial
Methods: A parallel-group, randomized controlled trial was conducted in the restorative dentistry clinics of a tertiary hospital in Khyber Pakhtunkhwa (KPK), Pakistan. Adults requiring direct posterior restorations (Class I/II) in vital permanent teeth were randomized 1:1 to receive either a bioactive glass–based restorative approach (intervention) or a conventional filling approach (control). Sensitivity was assessed using the Visual Analog Scale (VAS, 0–10) and standardized stimulus tests at baseline; 48 hours; 1 week; 1 month; 3 months; 6 months; and 12 months. The primary endpoint was change in postoperative sensitivity over time. Secondary endpoints included restoration retention and clinically relevant adverse outcomes. Analysis followed intention-to-treat principles with longitudinal modeling for repeated measures.
Results: Of 180 patients assessed, 120 were randomized (60 per arm). At 12 months, 58 participants in the bioactive glass group and 56 in the control group were available for analysis. Mean VAS decreased from ~6.1 at baseline to 2.8 at 48 hours in the bioactive glass group versus 4.1 in controls, with the between-group separation persisting through 12 months (0.3 vs 1.3). A higher proportion of participants achieved near-complete comfort (VAS ≤1) in the bioactive glass group by 12 months (88% vs 50%). Restoration retention at 12 months was high in both groups (98.3% vs 96.4%), with no material-related adverse reactions observed.
Conclusion: In this tertiary-hospital RCT, bioactive glass restorations were associated with faster and more durable reductions in postoperative tooth sensitivity than traditional fillings, while maintaining comparable clinical performance. These findings support consideration of bioactive glass approaches for sensitivity-prone restorative cases in high-volume public-sector settings.
