Monkey Pulpal Response to an MMA-based Resin Cement as Adhesive Luting for Indirect Restorations

Purpose: The objective of this study was to evaluate the pulpal response to a newly-developed MMA resin cement (MultiBond, Tokuyama) when used for adhesively luting composite resin inlays. Materials and Methods: Cervical cavities were prepared in monkey teeth. The teeth were randomly divided into 3 groups. In the experimental group, a self-etching primer and a resin cement were applied to the cavities, and then hybrid composite inlays (Estenia, Kuraray) were inserted using freshly mixed resin cement. In the other groups, a zinc oxide/eugenol cement (Eugedain, Showa Yakuhin Kakou) or a glass-ionomer cement (Fuji II, GC) was used to fill the cavity. The teeth were then extracted after 3, 30, and 90 days, fixed in 10% buffered formalin solution, and prepared using routine histological techniques. Five-µm-thick sections were stained with hematoxylin and eosin, or Brown & Brenn gram stain for bacterial observation. Histopathological reactions in the pulp tissue and bacterial penetration along the cavity walls were assessed using a standardized score. Results: No serious inflammatory reactions in the pulp, such as necrosis or abscess formation, were observed in any of the experimental periods, except for 1 case after 30 days, in which a pulpal exposure was suspected. Disarrangement of the odontoblast layer and deposition of reparative dentin were the major reactions observed in this specimen. No bacterial penetration along the cavity walls was detected. The monkey pulpal response and in vivo sealing ability of the MMA resin cement in combination with the self-etching primer was considered as good as that of the glass-ionomer cement. Conclusion: The new MMA resin cement showed acceptable biological compatibility to the monkey pulp when used to adhesively lute composite resin inlays. Keywords: MMA-based resin cement, indirect restoration, adhesive luting, pulpal response