Evaluation of pulpal response at varying remaining dentin thickness in teeth restored with resin bulk fill composite, conventional glass ionomer cement and silver amalgam: Histomorphometric analysis.

OBJECTIVE

To compare and evaluate the pulp response to GC glass ionomer cement, SDR plus bulk fill composite and amalgam against gold standard calcium hydroxide cement at varying remaining dentin thickness, in teeth planned for orthodontic extraction.

METHOD

Thirty-eight human premolars were prepared with 2 mm or 2.5 mm depth cavities. They were restored with GC conventional glass ionomer cement, SDR plus bulk fill composite, amalgam, or lined with Dycal and restored with GIC. Two teeth were used as intact controls. After a 7-day interval, the teeth were extracted and processed for histological examination of the pulp and the thickness of the remaining dentin between the cavity floor and pulp tissue.

RESULTS

All experimental groups showed some degree of inflammatory response. A significantly higher inflammatory response and more tissue disorganization were observed with SDR bulk fill composite (p < 0.05) compared to Glass ionomer cement, amalgam and Dycal at both cavity depths of 2 mm or 2.5 mm. The mean RDTs ranged from 346 μm to 1025 μm.

CONCLUSIONS

The study concluded that critical RDT varies for different restorative materials. It was observed that both glass ionomer cement and amalgam demonstrated acceptable biocompatibility when used in deep cavities. At the same time, SDR plus bulk fill composite proved to be the least biocompatible.