Pulpal reaction to a dental adhesive in deep human cavities

Abstract In the last years several dental adhesives have been developed. They are supposed to chemically adhere to dentin and a liner to protect the pulp is not used. The aim of this study was to compare the short-term pulpal reaction, in an intra-toothpair study, between a dental adhesive, Scotchbond 2, and a lining system, Tubulitec, in combination with P-50 in surface-sealed cavities. Deep buccal cavities in 16 human pairs of premolars, 32 teeth, were restored in vivo with a light cured composite resin, P-50. To minimize bacterial contamination all cavities were treated with a cleanser, Tubulicid, and the cavities were surface-sealed with temporary cement, Coltosol. One tooth in each pair, the test, was treated with Scotchprep Dentin Primer and Scotchbond 2 Light Cure Dental Adhesive. In the other tooth in the pair, the control, Tubulitec Primer and Liner were used. The teeth were extracted after 6–14 days. The sections where evaluated for degree of inflammation and the presence of bacteria. Irrespective of treatment of dentin the majority of teeth, 23, including one pulpal exposure, revealed no inflammation or a few inflammatory cells. In four test teeth, including one pulpal exposure, and two controls, growth of bacteria was found on the cavity walls and slight or moderate inflammation was seen in the corresponding pulps. In one test and two control teeth slight inflammation was seen but no bacteria could be detected. In the absence of bacteria Scotchbond 2 did not seem to irritate the pulp. However, in almost one third of the restorations the bond strength to dentin was not sufficient to resist the contraction forces during polymerization as indicated by bacterial growth at the interface between dentin and adhesive/composite.