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Pulp protection refers to protection of pulp from external irritants. Restorative dental materials provide
excellent properties for bulk of dental restoration . But do not protect pulp or preserve its health
Considerations include :
Chemical protection
Electrical protection
Thermal protection
Pulp medication
Mechanical protection
2) If insult produces fluid flow, in or out of dentinal tubules, pressure change is sensed by
mechanoreceptors within pulp and patient experiences sensitivity.
3) Leakage of chemical irritants from bacteria or dental materials- pulp becomes inflamed
4) Smear layer
1. It is 25 % to 30 % porous
2. Produce dentinal tubule sealing
3. Long term diffusion can occur so necessitates sealing of smear layer for chemical protection
CLASSIFICATION OF PULP PROTECTIVE AGENTS
1. Cavity sealers
Cavity Varnish
Resin bonding agents
2. Cavity Liners
3. Cavity base
CAVITY VARNISH
Composition
Components
Structure
Physical properties
Chemical properties
1.Solubility Low
Mechanial properties
1.Tensile <1
strength(Mpa)
2.Elongation <0.1%
Biologic properties
CAVITY LINERS
Use depends on extent and location of preparation and restorative material to be used.
CALCIUM HYDROXIDE
Pulpal biocompatibility
Antibacterial activity
Disadvantages :
Low strength
high solubility
Advantages :
Good biocompatibility
Good strength
Fluoride release
Used to replace missing dentin or block undercuts in preparations for indirect restorations
Thickness : 1 2 mm
Eg. Zinc phosphate cement, zinc polycarboxylate cement, glass ionomer cement type (III)
Biocompatible
Mild to pulp
Fluoride release
Components
Structure
Chemical
properties
Mechanical
properties
2.Diametral - 17 -
tensile strength
(Mpa)
Biologic properties
Retention of soft dentin near pulp and medication of remaining dentin with calcium hydroxide
Reinforced GIC / reinforced zinc oxide eugenol over calcium hydroxide liner
Criteria :
No periapical involvement
Procedure
Remove all undermined enamel high speed handpiece with air water spray
To seal exposed pulp with material that promotes reparative dentin formation
Procedure :
Involve unfilled, liquid acrylic monomer mixture placed onto an acid etched and primed dentin surface
Bonding or etching or
To seal underlying tooth structure and bond amalgam to enamel and dentin
No chemical bonding
Advantage:
Dentin sealing
During restoration removal , difficult to completely remove restoration and assess liners and
bases
Solution liners provide only chemical protection for days or weeks,thin and brittle
Traditional calcium hydroxide liners dissolve, lose 10% to 30% volume over 10 or more years
Long term changes in both cement liners and bases not well characterized
Under these circumstances it is judicious to remove most liners and bases during rerestoration
procedure.
REFERENCES