Midterm pres/res
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| charge for caries excavation? fill? | at no cost to the patient. we will often temporize these teeth
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| what is the caries indicator used? composition: what does it stain? | sable seek -- Ultradent
FD& C dyes in a 70 % propylene glycol base.
staind DEMINERALIZED DENTIN
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| CARIES excavation steps | 1. spoon excavator
2. round bur (large to small) - Large not to hit the pulp
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| Caries Excavation Technique | once student feels caries removal is copmlete, rinse throughly, and then simply paint on the sable seek with the Mini brush tip, leave for 10 sec, rince and vaccum
2. if caries remain, remove with a large slow speed round bur or excavator
3.repeat as ne
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| problem with sable seek? | stains demineralized dentin greenish black. does not distinguish bw infecgted dentin and demineralized dentin
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| Characteristics of caries excavation with sable seek | the use of caries indicator DOES NOT affect the bond strength of resin and dentin2
2. any porous = stain (not just the demineralized dentin)
3. non-carious deep dentin = large tubules, more tubules = stain
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| what can b used to remove stain from sable seek? | Hydrogen peroxide
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| what can the sable seek stain? | from restorations, espcially those with less than perfect margins.
stain clothing. if done properly, detergent and warm water will typically remove any stain.
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| t/f no material that can be placed in a tooth provides better protection for the pulp than dentin. | T
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| what is the single most important factor in protecting the pulp from insult? | RDT (remaining dentinal thinckness)
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| at 2mm RTD = < .25 mm RTD = | little pulpal reaction ocurs when there is a 2 mm RTD or more
the greatest impact occurs when the RDT is less than .25mm
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| what is the sandwich tecqhinque, when is it used? | GI base beneath Resion or Amalgam
if estimated RDT is < 2mm + no pulp exposure + all caries removed used VITRABOND liner or GI base with Fuji II or IX for insulation and fluoride release.
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| direct pulp exposure can heal normally? what is required? | yes, but a bacteria free environment is required. with proper diagnosis and good clinical procedure, direct pulp capping should rarely be acquired.
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| indirect pulp cap | treat a near pulp exposure with a material that promotes reparative dentin formation.
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| direct pulp cap | pulp exposure treatment with material that SEALS and promotes reparative dentin formation
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| Mechanical pulp exposure | exposure site occurs due to operator error or misjudgement.
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| carious pulp exposure. | exposure site is the consequence of infected dentin extending into the pulp
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| tooth candidate for a INDIRECT PULP CAPPING | 1. have vital pulp 2.no history of spontaneous pain.
pain elicited during pulp testing with a hot or cold stimulus should not linger after stimulus removal
PA (x-ray) no eveidence or lesion of endodontic origin.
bacteria excluded from site (rubber d
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| treatment of deep caries lession: | 1.place rubber dam
2. perp tooth
3. use slow speed in CONJUNCTION with spoon
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| what lining is used when preping tooth? | Calcium Hydroxide liner (DYCAL) over remaining demineralized dentin.
place RMGI (vitrabond Plus) to ensure the margins are completely coverd and seal.
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| a direct retoration procedure | place final restoration for bonded alagam or composite.
if no time use GI (fuji IX) the indirect pulp capping should not be disturbed during the subsequent restoration process.
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| indirect restoration procedure | place a defnite build up (bonded amalgan composite, GI) for cast metal, ceramic onlays, or crowns at the appointment in which the indirect pulp capping procedure was performed
delay placement of final restoration 4-8 months to ensure pulp vitality.
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| protocol for direct pulp capping from a mechanical exposure | exposure is small
free of contamination
relative atraumatic, little dessication of the tooth, no aspiration of blood
hemorrgage is controlled
caries exposure is not evident
tooth was symptom free
patient is young.
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| recomendation for the american journal of dentistry | control the hemorrhage (cotton pellet) -- No control extirpate the pulp
apply a thin layer of CaO2 (dycal) to and beyond exposure allow to harden
place 1-2 Vitrebond beyond margins - light cure
restore tooth
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| musod protocol fot a carious pulp | >.5mm , cannot achieve hemostasis, extirpate and procede with endodontic therapy
< .5mm follow protocol as mechanical exposure.
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| benefits of glass ionomer? | direct bond to tooth. - no bonding agent required.
bond to moist
F protec
excellent marginal seal - no shrinkage
thermal expansion = tooth
biocompatible = ideal for dentin
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| temporization procedure | prep tooth
select shade
apply GC conditioner
rinse and semi-dry
shake capsule to loosen powder, depress plunger to activace
t4riturate for 10 sec
immediately load capsule into GC capulse and apply w/i 10 sec
finish with standerd techniques
apply s
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| in teeth with questionable diagnosis , what is recommended? | control restoration is indicated.
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| a compromised tooth is best restored by? | indirect restoration (crown- onlay)
helps prevent tooth faction caused by mastication
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| inadequate conventional retention? | pin, slots, grooves enhance retention AND resitance form
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| INDICATIONS for complex amalgam and resin build-ups? | large excavations-- control excavations that have a questionable pulpal or perio prognosis. control rest in teeth with several caries lesions
definitive final restonations when finance is an issue
cores (foundation)
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| CONTRAINDICATIONS for compx amalgam and resin build ups? | esthetics (amalgam)
significant occlusal problems
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| SOLTS- restoration retention | in he horizontal plane = groove
conjunction or alternative to pins
at least .5mm deep and 1.0 mm length
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| pins vs. slots | retention potential NOT MUCH different.
pins are used more n preps w/few or no vertical wall
PINS more adequate if not much enamel tooth structure remains(decrease bonding potential)
Slots require more tooth to be eliminated.
slots = less micro fractu
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| when preping pre-molar which side bevel | 1 mm bevel on the lingual side
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| caries excavation are done to? | give students experience with caries removal, as well as to determine which teeth may be incorporated into the final treatment plan. (if tooth is restorable)
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