Critical appraisal. Current usage of glutaraldehyde/HEMA

Abstract

The use of glutaraldehyde/2-hydroxyethylmethacrylate (HEMA) combinations has been recommended for routine use in restorative dentistry by many authors and opinion leaders. Clinical restorative sites are colonized by bacteria that can contribute to postoperative sensitivity or recurrent caries. The structure of dentin allows for fluid conductance, which has been identified by Brännström as the cause of dentin sensitivity and as well, its water content challenges short- and long-term adhesion. The glutaraldehyde/HEMA combination is stated to be antimicrobial, a flocculating agent that strengthens collagen, and an agent that can create tubular occlusion, thereby reducing postoperative sensitivity by limiting fluid movement without affecting the strength of bonding or adhesive cements. This Critical Appraisal reviews five publications that deal with the various issues and clinical challenges described above, and provides suggestions for additional reading. A Bottom Line summary is provided.