Evaluation and treatment of bacterial microleakage

Recent data have shown a correlation between pulp response and material biocompatibility when microleakage is prevented. Considering vital dentin, the dentist must keep in mind that it is an extension of the pulp, presenting the first line of response to the consequences of microleakage. Healing of the dental pulp is ensured when a clinical seal is provided to prevent bacterial microleakage. Microleakage is a biological phenomenon with several important clinical implications. The affective component clinically presents as dentin postoperative hypersensitivity due to the episodic hydrodynamic fluid movement within the tubule complex. The effective component is the disease process which signals the dentin and pulp complex to respond by deposition of sclerotic and reparative dentin deposition. Uncontrolled microleakage generally produces patient pain as well as to later allow bacterial infection resulting in recurrent caries and pulp inflammation. The dynamic, permeable nature of the dentin interface allows residual bacteria to proliferate following cavity preparation. Following sterile operative procedures, bacteria have been shown to percolate into the cavosurface margin resulting in recurrent caries and pulp inflammation. This report considers biological data emphasizing the clinical necessity to provide a hermetic seal to prepared dentin to prevent both dentin hypersensitivity and pulp inflammation.