Pulpal reaction to composite resin restorations

Abstract

\/ omposite resin materials appear to be gaining in popularity. A report of their physical properties implied that they are superior to silicate cement and the coldcuring acrylic resins. In some situations composite resin materials are suitable for use in the restoration of posterior teeth.l Histologic studies of the effect of composite resin materials on the pulp are few and are concerned mainly with Addent 35t-the first such material to appear on the market. It has been suggested that the pulp reaction to this resin may be slightly less “severe” than to other cold-curing materials, and it was apparently difficult to find an effective liner that would prevent reactions to the Addent 35.* Stanley, Swerdlow, and Buonocore3 found that without a liner this material gave a mild response at first but that it increased in intensity with time. They considered that the proved polyvinyl cavity liner recommended for Addent 35 did not always provide adequate protection of the p~lp.~ In another study conducted by Baume and FioreDonno, pulp injury was found to be particularly severe under deep cavities with Addent 35, and the polyvinyl liner recommended by the manufacturer did not protect the pulp, though calcium hydroxide paste did. Sayegh and Reed5 studied the response beneath 36 Blendantl fillings in human teeth and, as a rule, found a mild response. No histologic examinations of the effect on the pulp of the new materials Addent 12 and Adaptics appear to have been published. The question of whether these materials are acceptable from the biologic aspect remains unanswered, and this applies to whatever kind of protection is used should damage to the pulp occur. In a separate study, 6 bacteria were detected on the walls of 56 of 66 unlined cavities restored with Adaptic, Addent 12, or DFR.11 Under 19 of these restorations, bacteria were observed in the dentinal tubules and in the pulps of three teeth. Only with