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ANALYSIS OF PULPAL REACTIONS TO RESTORATIVE PROCEDURES, MATERIALS, PULP CAPPING, AND FUTURE THERAPIES

Department of Oral Biology, Indiana University School of Dentistry, 1121 West Michigan Street, Indianapolis, IN 46202-5186;

Thomas W. Smyth

Department of Dentistry, St. Francis Hospital and Medical Center, Hartford, CT 06105

Abeer A. Hafez

School of Dentistry, University of Southern California, Los Angeles, CA 90089-0641

Charles F. Cox

Department of Restorative Dentistry, School of Dentistry, University of California at Los Angeles, Los Angeles, CA 90095-1668

*corresponding author, petmurra{at}iupui.edu

Every year, despite the effectiveness of preventive dentistry and dental health care, 290 million fillings are placed each year in the United States; two-thirds of these involve the replacement of failed restorations. Improvements in the success of restorative treatments may be possible if caries management strategies, selection of restorative materials, and their proper use to avoid post-operative complications were investigated from a biological perspective. Consequently, this review will examine pulp injury and healing reactions to different restorative variables. The application of tissue engineering approaches to restorative dentistry will require the transplantation, replacement, or regeneration of cells, and/or stimulation of mineralized tissue formation. This might solve major dental problems, by remineralizing caries lesions, vaccinating against caries and oral diseases, and restoring injured or replacing lost teeth. However, until these therapies can be introduced clinically, the avoidance of post-operative complications with conventional therapies requires attention to numerous aspects of treatment highlighted in this review.

Key words. Cavity preparation, cavity restoration, dental materials, growth factors, inflammation, bacterial microleakage