Human pulpal response to direct filling gold restorations

Class V cavities were prepared in 47 caries-free premolars intended to be extracted for orthodontic reasons. A powdered gold filling material, Goldent, which can be hand condensed, was used for direct fillings. The following test groups were used: (A) cavity preparation, no filling, (B) cavity filled with Goldent only, (C) cavity lined with Tubulitec and filled with Goldent, (D) cavity with Goldent filling, sealed with IRM, and (E) positive and negative controls. The teeth were extracted after 1-200 days and the pulpal response was histologically examined. The results revealed that only in Group B, i.e. when the cavity was filled with Goldent, was the risk of a pulpal reaction obvious, although the material per se (Group D) did not influence the pulpal tissue to any serious degree. Probably the Goldent material cannot provide a marginal seal tight enough to prevent microleakage, allowing microorganisms to give rise to pulp damage and inflammation. In those cases where the cavity had been isolated with Tubulitec liner before the gold restoration was made, the pulp was effectively protected from damage caused by microorganisms.