Pulp reactions to dental materials

Abstract

The dental pulp is-beside the periodontal tissues and the oral mucous membranes-the prime local target organ for direct or indirect biologic interaction with dental materials. Dental materials are not only classical restorative materials and those needed in the course of fabricating the restorations (e.g., impression materials) but also substances like tooth-whitening products or preventive varnishes. Due to its anatomical characteristics containing tubule with odontoblastic processes and lateral processes, the dentin is not only permeable, but it is also itself as a vital tissue biologically responsive, and thus any contact of a material or substance with dentin may possibly interfere with the dental pulp. Even the dental enamel is permeable for certain small molecules like hydrogen peroxide, which is released from tooth-whitening products, and again the pulp is the final target organ. Clinically, pain, pulp inflammation, or even pulp necrosis may result after contact with such materials, but often pulp damage occurs without overt clinical symptoms. However, through proper precautions, pulp damage can often be prevented. Furthermore, dental materials may not only damage the dental pulp, but they may also inhibit repair and/or regeneration. Thus, dental materials may interfere with the final aim of pulp therapy, namely, to keep the dental pulp vital. The topic of this chapter Pulp Reactions to Dental Materials covers a large area. Due to the limited space of this chapter, mainly general mechanisms of material-related pulp reactions as well as methods for preventing pulp damage and for stimulating pulp repair/regeneration are outlined. More detailed information especially on material groups is available in the literature.