Pulpal studies: biocompatibility or effectiveness of marginal seal?

Standards presently used to evaluate the biologic compatibility of dental restorative materials are examined and their inherent shortcomings are noted in this report. Studies citing the alleged effects of dental materials on the pulp are reviewed and compared to new theories, which suggest that the principal cause of pulpal inflammation is bacterial infiltration. Thus, studies that are not able to exclude bacteria as a variable cannot be used to draw conclusions as to the cause of inflammatory changes. This paper presents a proposal to alter the current biocompatibility testing methods to methods that can distinguish between the effects of materials and the effects of bacteria on the pulp.