Pulpal inflammatory responses following non-carious class V restorations

Area of Science:

• Restorative Dentistry
• Dental Materials Science
• Pulpal Biology

Background:

• Surgical interventions and restorative procedures can cause pulpal inflammation.
• Bacterial microleakage at the restoration-tooth interface is a significant concern.
• Understanding factors influencing pulpal inflammatory activity is crucial for long-term dental health.

Purpose of the Study:

• To investigate the combined effects of cavity preparation and restoration materials on pulpal inflammatory activity.
• To assess the role of bacterial microleakage in modulating pulpal inflammation.
• To evaluate the influence of remaining dentin thickness on inflammatory responses.

Main Methods:

• Evaluation of 202 restored Class V cavities.
• Assessment of pulpal inflammatory activity in relation to bacterial presence and restoration materials.
• Monitoring of inflammatory responses over time (20 and 30 weeks post-operatively).

Main Results:

• Bacterial infection significantly increased the severity of pulpal inflammation.
• Zinc oxide eugenol and resin-modified glass ionomer cement effectively prevented bacterial microleakage and severe inflammation.
• Enamel bonding resins and adhesive bonded composites allowed bacterial ingress, leading to severe inflammatory activity.
• Remaining dentin thickness influenced the grade of pulpal inflammation.
• Inflammation decreased over 20 weeks in non-infected cavities but remained stable for at least 30 weeks in infected cavities.

Conclusions:

• Bacterial microleakage is a primary driver of severe pulpal inflammation following cavity restoration.
• Material selection is critical; some materials provide better sealing and reduce inflammatory risk.
• Remaining dentin thickness and the presence or absence of infection dictate the progression and severity of pulpal inflammation.