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