Polymerization stress--is it clinically meaningful?
Level 5 - mechanism / opinion, no new human data
Narrative review of in vitro and clinical literature without systematic methodology
PubMed 26220776 · doi:10.1016/j.dental.2015.06.020
What was done
The author reviewed literature retrieved from PubMed and article reference lists regarding polymerization contraction stress generation in dental composite restorations, focusing specifically on evidence derived from clinical investigations.
What was found
The abstract reports no numerical data or quantitative effect sizes. It reports extensive in vitro evidence that polymerization stress produces marginal leakage, gap formation, cuspal deflection, tooth cracking, reduced bond strength, and compromised mechanical properties. However, it found no direct clinical evidence linking contraction stress to reduced restoration longevity, enhanced postoperative sensitivity, or recurrent caries.
Why it matters
This review highlights a critical disconnect between standard laboratory assumptions and clinical reality, showing that widespread clinical handling techniques aimed at reducing shrinkage stress are driven primarily by indirect laboratory proxies rather than direct clinical trial evidence.
Limits
The paper is a narrative review with no formal systematic search criteria, quality appraisal, or study count reported in the abstract. The underlying literature relies heavily on in vitro surrogate endpoints rather than direct human clinical outcomes.
Cited by
- supports Light curing large resin fillings creates shrinkage stress that exerts tensile force on the tooth and causes postoperative sensitivity and microfractures.