Current status of pulp capping with dentin adhesive systems: a review

Area of Science:

• Dentistry
• Biomaterials Science
• Regenerative Medicine

Background:

• Numerous studies have examined the morphology, bond strength, and sealing capabilities of dentin adhesive systems.
• However, limited in vivo research exists on the biocompatibility of these systems when applied to deep dentin or directly to the pulp in human teeth.
• While animal studies (non-human primates, rats) suggest pulp healing and dentin bridging with bonding agents, clinical evidence in humans is less extensive.

Purpose of the Study:

• To review existing literature on pulp responses to total acid etching and adhesive resin application in deep cavities or pulp exposures.
• To compare and discuss clinical and radiographic evidence of successful vital pulp therapy.
• To evaluate the consistency of results between animal and human studies regarding pulp capping agents.

Main Methods:

• Comprehensive literature review of in vivo and in vitro studies.
• Analysis of studies evaluating pulp responses to various dentin adhesive systems.
• Comparison of outcomes from animal models versus human clinical trials.

Main Results:

• Self-etching adhesive systems demonstrated potential safety and efficacy on dentin.
• Human pulps treated with bonding agents exhibited persistent inflammation, delayed healing, and failed dentin bridging.
• Results from animal studies could not be directly extrapolated to human clinical scenarios.

Conclusions:

• Self-etching adhesive systems appear safe for dentin application.
• Bonding agents applied directly to human pulps can lead to adverse inflammatory responses and impede healing.
• Vital pulp therapy utilizing acidic agents and adhesive resins is contraindicated in human teeth due to unpredictable outcomes and potential for failure.