THE BIOCOMPATIBILITY OF NON-AMALGAM DENTAL FILLING MATERIALS

Non-analgam filling materials may release substances which base been s hown to be toxic in cytotoxicity tests and implantation studies. Howev er. results from systemic toxicity tests do not indicate any unaccepta ble risk to the patient's general health, but data for non-amalgam den tal filling materials are scarce in comparison to amalgam. Although es trogen-libe effects of one fissure sealant have been claimed, no concl usions can be drawn at present far the patient From these in vitro dat a because of the limitation of the test methods and materials used. So me components of composite resins/dentin adhesives and a resin-modifie d glass ionomer cement were mutagenic mainly in in vitro tests. Due to the limitations of the test systems and the comparatively high concen trations needed to elicit the reactions, no unacceptable risk can yet be derived from those data for the patient. However, a no-touch techni que is recommended for the denial personnel, As with amalgam, local re actions of the pulp are not expected with alternative filling material s, if the pulp tissue is not exposed and if bacterial penetration is a voided. The latter requirement is stili difficult to fulfill, especial ly for composite resin systems and related materials in posterior teet h situations. Slight gingival reactions to alternative filling materia ls and to amalgams are mainly attributed to plaque accumulation. From all these data it can be concluded that, for the time being, it is not possible to rank dental filling materials in respect to their biocomp atibility, and it is evident that biocompatibility must be considered to the same extent for both amalgams and commonly used or recommended alternative filling materials.