Pulp reactions in human teeth capped with self-etching or total-etching adhesive systems

Objective: Restorative procedures of the dentin-pulp complex stimulate damages that, depending on the technique and materials used, may induce pulpal reactions. The purpose of this study was to evaluate immunochemistry, morphologic, and morphometric pulpal alterations of human teeth pulps capped with self-etching or total-etching adhesive systems. Method and Materials: Thirty human third molars were restored with a resinbased composite and adhesive system, either Clearfil (Kuraray; n = 10) or Scotchbond (3M ESPE; n = 10). After 7, 30, or 60 days, the teeth were extracted and longitudinally sectioned. The pulps were removed for histopathologic and immunochemistry evaluation for interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, and inducible nitric oxide synthase (iNOS). Results: The density of fibrous connective tissue was significantly higher after 30 days in both groups (P .001). Congestion, hemorrhage, calcification, and swelling of the odontoblasts were similar in both groups. The total capillary area was significantly higher after 7 and 30 days in both groups. Positive immunoreactions for iNOS were found in 1 case (20%) of the 30-day Scotchbond group. Immunoreactions for IFN-gamma were positive in a few cells in 1 case (20%) of the 7-day Clearfil group. There were no positive immunoreactions for TNF-alpha in any case. Conclusion: No inflammatory reactions, necrotic areas, or severe immunoreactions for proinflammatory cytokines were found, suggesting biocompatibility of self-etching or total-etching adhesive systems when placed directly on dentin. Keywords: adhesive systems, immunohistochemistry, marginal microleakage, morphology, morphometry, pulp reactions, teeth