PULP - LININGS 2

WHAT USE - WHERE AND WHEN
Cavities of 2mm or less - no lining
slightly deeper than 2mm - lining to be used
WHERE TO USE
1. Pulpal -axial wall and or occ floor
2. ie areas directly overlying the pulp
PULP PROTECTION - DEEP CARIES
1. Try avoid pulp exposure - bacteria likely to penetrate the chamber
2. discomfort when caries reaches 0.5mm from pulp
3. Indirect pulp cap, direct pulp cap, stepwise excuvation
INDIRECT PULP CAP
1. When cavity extends within 0.5mm of pulp
2. capping material - calcium hydroxide applied to deepest part
3. May be covered with resin modified glass polyakenoate (vitrebond)
4. Restored as normal
DIRECT PULP CAP
1. When an exposed pulp is covered by capping material
2. hard setting calcium hydroxide ormineral trioxide aggregate MTA
3. CRITERIA
4. Tooth is vital and no history of pain
5. no periradicular pathology
6. pulp pink and healthy - no excessive bleeding
7. If any of the above - RCT required
8. DIRECT PULP CAP TECHNIQUE
  1. microexposure dried with cotton wool - NO air dry!
  2. Pulp cap material applied to exposure
  3. Resin modified Glass ionomer may be applied on top
  4. Tooth restored as normal - pt advised to return if any probs/pain with tooth
  5. If in any doubt refer to dentist
STEPWISE EXCUVATION
1. Used when trying to avoid pulp exposure
2. When stained soft dentine is left in base of cavity but ADJ is clear
3. If carious seems unavoidable follow stepwise procedure
4. Seal over entire base of cavity where caries remains with calcium hydroxide
5. Dress tooth with GI Cement
6. Remove Gi and Lining 6-12 months later
7. Base of cavity should still be stained but now firm
8. Action of Calcium Hydroxide has arrested caries
9. Tooth can now be restored with permanent material

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PULP - LININGS 2

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