Amalgams in deep, unlined cavities cause

• A. Inflammation
• B. Reparative dentin
• C. No reaction
• D. Hyperplasia

Answer: (A)

When a metallic restorative like amalgam is placed in a deep cavity with little dentin left between the filling and the pulp, the pulp is exposed to more irritants from the material and any microleakage over time. Amalgam and its byproducts can irritate the pulp, triggering an inflammatory response. This pulpal inflammation is the typical reaction when the tooth structure protection is thin and no protective liner is used. While the pulp can later lay down reparative (tertiary) dentin as a protective measure if the irritation is mild and the pulp remains viable, the immediate and most likely outcome in this scenario is inflammation. No reaction would be unlikely given the close proximity to the irritant, and hyperplasia is not the common initial response to this situation.