Pulpal responses to ionomer cements - biological characteristics

Article Abstract:

Glass ionomer cements were initially used only as restorative materials (materials used for filling cavities), because whether they were sufficiently compatible with biological tissues to be used in other ways had not been determined. Later evidence suggests that they are similar to other cements in this regard. Dentin, the material surrounding the tooth pulp, and the pulp itself (the core of the tooth, containing blood vessels and nerves) in fact make up one organ, and any substance that contacts the dentin will eventually affect the pulp. Thus, the idea that a restorative material applied to dentin cannot affect the pulp is not correct. Dentin is composed of fluid-containing tubules and it is most permeable (porous) near the pulp. The effect of reduced permeability far from the pulp is to shield the pulp from toxic materials, since they will not be absorbed into the tubules. When dentinal thinning occurs, it offers less protection. Acids from food, microorganisms, or restorative materials are highly destructive to teeth. Many cements in routine use are toxic, especially when used as luting agents (agents to coat the tooth to seat a crown). Microscopic sections of teeth after application of zinc phosphate reveal signs of inflammation in the pulp. Cements generally become less acidic as they set. Glass ionomer cements have a slow setting time and can therefore introduce considerable acidity into the mouth. Before application, they also require that the tooth be acid-etched (a process of removing potentially contaminating material from the tooth by use of an acid), which itself can damage the dentin. The merits of several preparations with respect to their effect on hypersensitivity of the treated area are discussed. It is concluded that glass ionomer cements are approximately as compatible with the body as other cements and technical suggestions for overcoming their disadvantages are provided. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Dental pulp

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Sensitivity restored of class V abrasion/erosion lesions

Article Abstract:

Tooth roots can become sensitive as a result of several factors, including the use of abrasive pastes, brushing, occlusal stress, or dietary changes. Cervical Class V abrasion/erosion lesions represent situations where the dentin (closest to the tooth pulp, normally covered by cementum near the root) becomes exposed. The dentinal tubules that make up dentin may become blocked, and sensitivity develops. To evaluate the effectiveness of different approaches to restorative treatment, 24 patients with 108 such lesions were studied. Three materials were used: glass ionomer cement, microfil composite resin with a dental adhesive, and microfil composite with a dental adhesive and a light-cured glass ionomer liner. All three treatments were performed for each patient, and sensitivity was assessed for the teeth after the restoration, at one week, and at six months later. Sensitivity to biting, air, hot and cold water, and brushing, were determined. Before treatment, 23 patients had sensitivity in at least one tooth, more frequently to cold. Discomfort was caused by cold water in 71 lesions (66 percent), hot water in 49 (45 percent), and air in 28 (26 percent). Older patients tended to report less sensitivity, and posterior teeth tended to be more sensitive to air and cold than anterior ones. Results of the efficacy of the different restorative materials are presented in the form of graphs. Sensitivity to air and hot water was reduced by all treatments in most cases, but 24 percent of the glass-ionomer restorations became more sensitive to air. Fewer (six percent) of the restorations performed with composite resin became sensitized to air. Cold sensitivity increased after one week for 27 percent of the lesions treated with composite resin and a glass ionomer liner, but at six months, those treated with composite resin with a dental adhesive showed the greatest cold sensitivity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Injuries, Causes of, Teeth, Dental resins, Toothache, Tooth abrasion, Dental materials, Dental acrylic resins

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