The objective of this systematic review was to assess, evaluate, and analyze the pulpal biocompatibility and solubility of various contemporary luting cements utilized in fixed prosthodontics. The scope of the evaluation included emphatically self-adhesive resin cement and resin-modified glass ionomer cements, which are some of the most used cements in restorative practices in Saudi Arabia and other countries around the globe. Electronic searches were performed in PubMed, Scopus, ScienceDirect, and Google Scholar until April 2024. Selected studies evaluated pulpal responses for biocompatibility or the solubility properties of permanent luting cements incisively and in vitro or in vivo. Studies were screened with PRISMA guidelines, and the risk of bias was assessed employing conventional methods. Ten studies matched the eligibility criteria. Significant results were obtained from resin-based luting cements like Panavia F, Multilink Automix, and Variolink II, which demonstrated lesser water sorption and solubility values in comparison to Fuji Plus, a glass ionomer resin modified cement. All materials were found to be more soluble in acidic environments, although more stable in resin cements. Biocompatibility testing conducted through cytokine release and MTT assays indicated that the majority of resin cements caused minimal inflammatory response and were deemed non-toxic. There is also some potential for pulpal irritation associated with increased cytokine release with some of the resin-modified cements. These results corroborate the rationale for preferring resin-based luting materials in the clinical setting of Saudi Arabia, where dental professionals need dependable and enduring cementation options. Additional region-targeted studies and in vivo research are warranted.
