Clinical Behavior of an MDPB-containing Adhesive in Periodontal Patients

Objectives: The majority of clinical trials concerning pulp reactions when resin materials are placed in deep cavities, performed in young pulps, with a high regenerative capacity. Everyday clinical practice however, regards teeth with questionable pulp condition. This is a clinical study of pulp condition in periodontal teeth, after application of an antibacterial adhesive system, in deep cavities. Methods: Forty-six viable, caries free, human teeth scheduled for extraction due to periodontal reasons from patients 40-50 years old were used. The protocol was conducted according to guidelines for research in humans in Aristotle University of Thessaloniki. Class V cavities (approximately 2.50 mm wide, 3.00 mm long) were prepared on the buccal surface of teeth. Cavities were randomly divided in two groups and filled as follows: group A: Protect Bond/ Clearfil AP-X and group B: Dycal/Ketac Fill Plus. Teeth were extracted 4 or 8 weeks postoperatively and prepared for histological assessment. All sections were stained either with Mayer's hematoxylin-eosin stain or using modified Brown-Brenn's technique. The criteria used to assess the connective tissue reactions were: inflammatory cell response, tissue disorganization, tertiary dentin formation and remaining dentin thickness. Statistical analysis was performed by SPSS 15.0 using 2-way ANOVA, Kruskal Wallis test and Mann Whitney test (p=0.05). Results: Bacteria infiltration of the pulp was not present in any specimen. In few specimens bacteria were found along the cavity walls or within the cut dentinal tubules. No severe inflammation or severe tissue disorganization was demonstrated. Tests showed no statistical significant differences regarding to inflammatory cell response and tissue disorganization among groups. Hard tissue formation was not seen in any teeth. Conclusions: It may be concluded that placing a resin adhesive with antibacterial properties in deep cavities with close proximity to pulp cavity is a safe procedure.