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Postoperative Tooth Sensitivity Following Class II Composite RestorationsNCT07212413

Effect of Snow-plow Technique on the Postoperative Pain Following Direct Composite Restoration

A study testing Snow-plow restorative technique and Resin coating restorative technique in people with Postoperative Tooth Sensitivity Following Class II Composite Restorations, run by University of Jordan at 1 site in Jordan.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This study is designed to compare two modern techniques used to restore decayed back teeth with tooth-colored filling materials. Some patients experience temporary discomfort or sensitivity after these types of dental treatments. Read more about this study

Who is it for?
Ages 18 to 50 yearsHealthy volunteers can take part
What is being tested?
Snow-plow restorative technique and Resin coating restorative technique
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
1 siteJordan
Study dates
12 Jan 2025to 6 Oct 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Adult patients aged 18-50 years.
  • Systemically healthy individuals.
  • Presence of two posterior teeth in different quadrants or contralateral sides of the same arch requiring Class II composite restorations.
  • Teeth diagnosed with reversible pulpitis and vital pulps, confirmed clinically and radiographically.
  • Teeth without previous restorations or carious lesions limited to dentin.
  • Ability to provide informed consent and comply with study procedures and follow-up assessments.

Who cannot join

  • Non-vital teeth, teeth with signs of irreversible pulpitis, periapical pathology, or extensive loss of tooth structure.
  • Patients with systemic conditions or medications that may influence pain perception, healing, or sensitivity (e.g., chronic pain syndromes, analgesic use, immunosuppressive therapy), or very poor oral hygiene.
  • Pregnant or breastfeeding women.
  • Known allergy to dental materials used in the study.
  • Inability to respond to follow-up calls or provide reliable pain assessments.
  • Teeth with previous restorations, endodontic treatment, or cracks.

Trial locations and contacts

1 site in 1 country.

Jordan1 site
  • Univeristy of Jordan Hospital, Dental Department

    Amman

Other trials in Jordan

About this study

Official title: Postoperative Sensitivity in Class II Restorations: A Randomized Clinical Trial Comparing Snow-Plow and Resin Coating Techniques

This study is designed to compare two modern techniques used to restore decayed back teeth with tooth-colored filling materials. Some patients experience temporary discomfort or sensitivity after these types of dental treatments. The purpose of this study is to learn whether one technique may help reduce this short-term sensitivity compared to the other.

Adults who need fillings on both sides of their mouth are invited to participate. Each patient will receive one filling using each technique, placed in different teeth during the same appointment. The procedures will be performed using standard clinical methods and materials.

After treatment, participants will be contacted by telephone to report any discomfort at several time points during the first week. The interviewer will not know which technique was used for each tooth to ensure unbiased reporting. This information will help dentists better understand how these techniques affect patients' comfort in the days following treatment.

Read the detailed description

Postoperative tooth sensitivity is a common but often transient symptom following the placement of direct posterior resin composite restorations. Patients frequently report mild to moderate discomfort, particularly during the first few days after treatment, which can influence their perception of treatment success and overall satisfaction. While advances in adhesive dentistry and restorative materials have greatly improved clinical outcomes, postoperative sensitivity remains a relevant clinical concern.

This clinical trial is designed to compare two contemporary restorative techniques-the snow-plow technique and the resin coating technique following immediate dentin sealing-in terms of postoperative patient-reported pain during the first postoperative week. Both techniques aim to enhance marginal adaptation and reduce polymerization shrinkage stresses at the adhesive interface, thereby potentially minimizing pulpal irritation and postoperative discomfort.

Participants in this study are adult patients requiring Class II resin composite restorations on two comparable posterior teeth, typically located on opposite sides of the dental arch. Each participant will receive two restorations, one using the snow-plow technique and the other using the resin coating technique, in a split-mouth design. This approach allows each participant to serve as their own control, minimizing inter-patient variability and enabling a more reliable comparison between the two restorative strategies.

All procedures are performed under rubber dam isolation using standardized adhesive and restorative protocols to ensure clinical consistency. The snow-plow technique involves placing an uncured flowable bulk-fill resin on the cavity floor, immediately followed by the placement of a packable composite increment. Both materials are then light-cured simultaneously. This technique is intended to improve adaptation of the restorative material to cavity walls, displace voids, and reduce microleakage.

In the resin coating technique, immediate dentin sealing is performed following cavity preparation. A thin layer of flowable bulk-fill resin is then applied over the sealed dentin and light-cured before the placement of the final packable composite increment. This layer acts as a stress-absorbing liner, providing a flexible interface that may protect the pulp and reduce the transmission of shrinkage stresses during polymerization.

Operator calibration and adherence to standardized protocols are emphasized to ensure uniformity. All restorations are carried out by a single experienced clinician using the same materials, instruments, and curing devices to reduce variability related to operator technique.

Postoperative discomfort is assessed using a standardized visual analog scale (VAS) during structured telephone interviews conducted at baseline (before treatment), 24 hours, 72 hours, and one week postoperatively. Interviews are performed by an assessor who is blinded to the restorative technique used for each tooth to minimize reporting bias. Participants are specifically instructed to evaluate each treated tooth independently without making side-by-side comparisons.

This study does not involve any experimental drugs or non-standard clinical procedures. Both restorative techniques are widely accepted in routine clinical practice and use materials that are commercially available and approved for dental use. The primary objective is to evaluate the early postoperative pain experience associated with each technique, rather than to introduce a novel material or intervention.

The findings of this study will contribute to a better understanding of how restorative technique selection influences postoperative sensitivity, potentially informing evidence-based clinical decision-making in restorative dentistry. By comparing two established but mechanistically distinct approaches, this trial aims to provide clinically relevant information that may help dentists optimize patient comfort following posterior resin composite placement.

Being tested
Snow-plow restorative technique, Resin coating restorative technique
Keywords
Postoperative sensitivity, Class II composite restoration, Snow-plow technique, Resin coating technique, Pain assessment

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Snow-plow restorative techniqueProcedure or surgery

    Also called Snowplow technique

    The snow-plow technique involves placing a thin layer of uncured flowable bulk-fill resin on the gingival floor of a Class II cavity, immediately followed by placement of a packable bulk-fill composite. Both materials are light-cured simultaneously, allowing the flowable resin to fill voids and improve marginal adaptation.

  • Resin coating restorative techniqueProcedure or surgery

    Also called Resin coating, Immediate dentin sealing with flowable liner

    The resin coating technique involves applying and light-curing a thin layer of flowable bulk-fill resin after adhesive application to create a stress-absorbing layer on dentin (resin coating), followed by restoration with packable bulk-fill composite. This approach aims to protect the dentin, enhance bond stability, and reduce postoperative sensitivity

Study groups in NCT07212413
Study groupRoleWhat they receive
Snow-plow techniqueExperimentalClass II posterior cavities were restored using the snow-plow technique. After adhesive application, a thin layer of uncured flowable bulk-fill resin was placed on the gingival floor. A packable bulk-fill composite was then immediately inserted, displacing the flowable resin, and both were light-cured simultaneously. The occlusal anatomy was completed with packable composite, followed by finishing and polishing. Rubber-dam isolation and selective enamel etching with a universal adhesive were applied in all cases.
Receives: Procedure: Snow-plow restorative technique
Resin coating techniqueExperimentalClass II posterior cavities were restored using the resin coating technique following immediate dentin sealing. After adhesive application, a thin layer of flowable bulk-fill resin was applied and light-cured to create a stress-absorbing layer on the dentin surface. Packable bulk-fill composite was then used to restore the remaining cavity, followed by occlusal sculpting, finishing, and polishing. All procedures were performed under rubber-dam isolation with selective enamel etching and universal self-etch adhesive on dentin.
Receives: Procedure: Resin coating restorative technique

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Postoperative pain intensity after Class II composite restorations

    Postoperative pain intensity will be assessed using a 0-10 Visual Analog Scale (VAS) at baseline (before treatment), 24 hours, 72 hours, and 1 week following restorative procedures. Each treated tooth will be evaluated individually using structured telephone interviews conducted by a blinded examiner. VAS scores will be recorded and analyzed to compare pain trajectories between the snow-plow and resin coating restorative techniques.

    Measured: Baseline, 24 hours, 72 hours, and 1 week after restorative treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Oct 2025
  2. Study start12 Jan 2025
  3. Primary completion24 Sep 2025
  4. Study completion6 Oct 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
A randomized split-mouth clinical trial with two intervention arms (snow-plow and resin coating techniques) allocated to contralateral Class II cavities in the same patient. This crossover model minimizes inter-individual variability by enabling within-subject comparison under identical clinical conditions.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
100 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07212413
Sponsor's protocol ID
2/5/1/200
Status last verified
Sep 2025
First submitted
30 Sep 2025
Last updated
8 Oct 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual participant data (IPD) underlying the results will be shared, including demographic data, intervention assignment, and all primary and secondary outcome measures. Data will be available to qualified researchers upon reasonable request following publication of the study results, in accordance with institutional and ethical guidelines. Supporting materials, such as the study protocol and statistical analysis plan, will also be provided.

Publications

  • Afifi SMH, Haridy MF, Farid MR. Evaluation of Post-Operative Sensitivity of Bulk Fill Resin Composite versus Nano Resin Composite: A Randomized Controlled Clinical Study. Open Access Maced J Med Sci. 2019 Jul 26;7(14):2335-2342. doi: 10.3889/oamjms.2019.656. eCollection 2019 Jul 30.

    PubMed 31592052
  • Lehmann A, Nijakowski K, Jankowski J, Donnermeyer D, Ramos JC, Drobac M, Martins JFB, Hatipoglu O, Omarova B, Javed MQ, Alharkan HM, Bekjanova O, Wyzga S, Alkhawas MAM, Kudenga R, Surdacka A. Clinical Difficulties Related to Direct Composite Restorations: A Multinational Survey. Int Dent J. 2025 Apr;75(2):797-806. doi: 10.1016/j.identj.2024.06.012. Epub 2024 Jul 23.

    PubMed 39048490
  • Tee R, Vach K, Schlueter N, Jacker-Guhr S, Luehrs AK. High C-Factor Cavities: How Do "Snowplow Technique", Adhesive Application Mode and Aging Influence the Microtensile Bond Strength to Dentin? J Adhes Dent. 2024 Jan 15;26:1-10. doi: 10.3290/j.jad.b4835909.

    PubMed 38224111
  • Putignano A, Tosco V, Monterubbianesi R, Vitiello F, Gatto ML, Furlani M, Giuliani A, Orsini G. Comparison of three different bulk-filling techniques for restoring class II cavities: muCT, SEM-EDS combined analyses for margins and internal fit assessments. J Mech Behav Biomed Mater. 2021 Dec;124:104812. doi: 10.1016/j.jmbbm.2021.104812. Epub 2021 Sep 3.

    PubMed 34500356
  • Tardem C, Albuquerque EG, Lopes LS, Marins SS, Calazans FS, Poubel LA, Barcelos R, Barceleiro MO. Clinical time and postoperative sensitivity after use of bulk-fill (syringe and capsule) vs. incremental filling composites: a randomized clinical trial. Braz Oral Res. 2019 Sep 16;33(0):e089. doi: 10.1590/1807-3107bor-2019.vol33.0089.

    PubMed 31531552
  • Miletic V, Komlenic V, Bajuk-Bogdanovic D, Stasic J, Petrovic V, Savic-Stankovic T. Preheating and "snow-plow" composite application technique affect double bond conversion but not bond strength to dentine. J Esthet Restor Dent. 2024 Jun;36(6):951-961. doi: 10.1111/jerd.13218. Epub 2024 Mar 18.

    PubMed 38497672

Questions about this trial

What is this clinical trial studying?

A study testing Snow-plow restorative technique and Resin coating restorative technique in people with Postoperative Tooth Sensitivity Following Class II Composite Restorations, run by University of Jordan at 1 site in Jordan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 8 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Jordan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Postoperative pain intensity after Class II composite restorations (time frame: Baseline, 24 hours, 72 hours, and 1 week after restorative treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07212413, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Oct 2025.

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