Microleakage related to restorative procedures. 1992

C F Cox
Department of Restorative Dentistry, University of Alabama, School of Dentistry, Birmingham.

A current Med-line search from 1966 to present cited over 344 juried publications employing the term microleakage. Dentistry recognizes microleakage as a multifaceted biological phenomenon. Brännström et al. (1967), Trowbridge (1982), Närhi (1983), and others have reported the sensory component of microleakage as a consequence of hydrodynamic fluid movement within the dentinal tubule complex. This movement of dentinal fluid has been demonstrated to displace nociceptive receptors which stimulate the nerves of the Group A fibers which run and terminate within the odontoblastic layer (see Matthews 1992). Penetration of oral fluids, bacteria and their toxic products within the preparation-material interface following material insertion accounts for the pathological component of microleakage (Browne and Tobias 1986). Continued microleakage of bacterial infiltrates eventually present as an inflammatory process which may initially signal the dentin complex to respond by deposition of a hypermineralized or sclerotic dentin. The pulp-dentin interface will repair with a specialized zone of reparative dentin. An overwhelming carious lesion often results in pulp infection and eventual necrosis. Vital dentin is an extension of the pulp, presenting the first line of defense to the consequences of microleakage. Recent publications have demonstrated that microleakage of dental materials in non-exposed and exposed pulps is a function of controlling bacterial infection. In an exposed mature dental pulp, the mesenchymal tissue permits the reorganization of pulp tissue and regeneration of a new dentin bridge in the presence of a biological seal. New odontoblastoid cells appear to regenerate from deeper pulpoblasts in the presence of various dental materials, apparently without an epithelial stimulating factor (Yamamura 1985). This inherent healing of the dental pulp and regeneration of a new dentin bridge is expressed in the presence of various dental materials, but only in the absence of bacterial infection. Data which evaluates the biological deposition of reparative and dentin bridges as either repair or regeneration are presented as a basis for considering the clinical selections of dental materials. Recent data demonstrate that dentin and pulp healing are ensured when a proper biological seal is provided to control and prevent microleakage.

UI MeSH Term Description Entries
D003763 Dental Leakage The seepage of fluids, debris, and micro-organisms between the walls of a prepared dental cavity and the restoration. Dental Leakages,Leakage, Dental,Leakages, Dental
D003793 Dental Restoration, Permanent A restoration designed to remain in service for not less than 20 to 30 years, usually made of gold casting, cohesive gold, or amalgam. (Jablonski, Dictionary of Dentistry, 1992) Dental Fillings, Permanent,Dental Filling, Permanent,Dental Permanent Filling,Dental Permanent Fillings,Dental Restorations, Permanent,Filling, Dental Permanent,Filling, Permanent Dental,Fillings, Dental Permanent,Fillings, Permanent Dental,Permanent Dental Filling,Permanent Dental Fillings,Permanent Dental Restoration,Permanent Dental Restorations,Permanent Filling, Dental,Permanent Fillings, Dental,Restoration, Permanent Dental,Restorations, Permanent Dental
D003804 Dentin The hard portion of the tooth surrounding the pulp, covered by enamel on the crown and cementum on the root, which is harder and denser than bone but softer than enamel, and is thus readily abraded when left unprotected. (From Jablonski, Dictionary of Dentistry, 1992) Dentine,Dentines,Dentins
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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