protecting the pulp

Question 1

what does the pulp need protected from?

Answer 1

bacterial insult, thermal discomfort, chemical attack

Question 2

what is an example of a chemical attack?

Answer 2

acids in dentine bonding agents, acrylic resin, constituents of certain restorative materials, residual acid and acidic bacteria

Question 3

what is an example of thermal discomfort?

Answer 3

polymerisation exotherm of some restorative materials, light curing units, food/drink, cavity prep

Question 4

how does cavity preparation cause insult?

Answer 4

the smear layer introduces bacteria, collagen and hydroxyapatite e.t.c into tubules increasing the inflammatory response

Question 5

describe the ideal pulp protection

Answer 5

non toxic, non irritant, bacteriostatic, good coronal seal, thermal/electrical insulator, radiopaque, strong, compactable, soothing.

Question 6

describe calcium hydroxide

Answer 6

Dycal, high pH (initially irritant)

Bacteriocidal, thermal/electrical insulator, radiopaque, good restorative compatibility, cant condense, not adhesive.

Question 7

describe glass polyalkanoates

Answer 7

>

Low pH, high molecular weight, bacteriostatic, fluoride release, insulator, strong, can condense.

Question 8

describe indirect pulp cap

Answer 8

hard setting calcium hydroxide applied to deepest part of cavity.

Question 9

describe a direct pulp cap

Answer 9

hard setting calcium hydroxide or mineral trioxide aggregate(MTA) applied to exposed pulp.

Question 10

what conditions are needed for a successful pulp cap

Answer 10

Tooth is vital
No history of pain 
No evidence of periradicular pathology 
Pulp is pink and healthy
No excessive bleeding

Question 11

describe stepwise excavation

Answer 11

To avoid pulp exposure
Soft dentine left at base but ADJ cleared
Dress with GI cement
Remove in 6-12mnths and base should be stained but firm, restore normally.