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Direct/Cariology > Pulp Protection Part I > Flashcards

Pulp Protection Part I Flashcards

1
Q

Define pulp protection therapy

A

the treatment that maintains pulp tissue in a healthy and functional state, whenever the dentin-pulp complex has been compromised by caries, trauma, or restorative procedures

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2
Q

What are the three different categories of pulp irritants

A
  • microbial
  • mechanical
  • chemical
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3
Q

Two different diseases caused by microbial irritants that can damage the pulp are

A
  • dental caries

- periodontal disease

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4
Q

Tooth preparation falls under what category of pulp irritants

A

mechanical (or operative)

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5
Q

The degree of plural reaction to operative procedures is dependent on what two factors

A

the amount of friction and desiccation

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6
Q

How can tooth preparations lead to plural damage

A

frictional heat generated by the drill can cause burn lesions in the pulp and access formation

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7
Q

what are the three different operative procedures that can cause pulpal damage

A
  • Tooth preparation
  • Orthodontics
  • Periodontal curettage (scaling and root planing)
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8
Q

What is one mechanical (not operative!) irritant that can cause plural damage

A

trauma

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9
Q

What are the objectives of pulp protection therapy

A
  • sealing the dentinal tubules
  • Thermal protection
  • Mechanical protection
  • Chemical protection
  • Electrical protection
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10
Q

Ideal pulp protecting agents should be (biologically/chemically) compatible

A

both

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11
Q

What are the ideal requirements of Pulp protecting Agents

A
  • Biologically/chemically compatible
  • Capable of forming a non-permeable layer on cut dentin with thickness, which does not affect the bulk or mechanical properties of a restoration
  • The pulp protection material should not discolor either the tooth or restorative material
  • The material should attain the hardness quick enough to allow the final restoration completed in adequate time
  • It should have low solubility in oral builds
  • Should have ease of use and manipulation during mixing and insertion
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12
Q

The best pulp protection is provided by what part of the tooth

A

the dentin

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13
Q

The remaining dentinal thickness (RDT) determines what

A

the effect of insult on pulp due to various irritants

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14
Q

The classification of pulp protection is based on what

A

the extent of the caries

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15
Q

What sorts of pulp protection should be employed for moderate carious lesions

A
  • sealers
  • liners
  • bases
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16
Q

What sorts of pulp protection should be employed for deep carious lesions

A
  • Direct pulp capping

- Indirect pulp capping

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17
Q

what is the difference between direct and indirect pulp capping

A

Indirect has less calcium-hydroxide than direct

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18
Q

what are the components of the direct and indirect pulp caps

A
  • Composite filling
  • Glassionomer lining
  • Calcium-hydroxide
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19
Q

What are cavity sealers

A

materials that provide a protective coating to the walls of a prepared cavity and a barrier to leakage at the interface of the restorative material and the walls

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20
Q

What are the two types of sealers

A

tarnishes and adhesive sealers

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21
Q

What is a varnish sealer

A

a natural rosin or gum (copal) or synthetic resin, dissolved in an organic solvent (acetone, chloroform, or ether)

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22
Q

what is an adhesive sealer

A

provides sealing as well as bonding at the interface between the restoration and the preped walls

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23
Q

Varnish is composed of a solid and liquid component what are they

A
  • Solid= copal resin

- Liquid= organic solvent (ether, acetone, or chloroform)

24
Q

What are the indications (or the positives of) for varnish sealer

A
  • Can be applied to every prepped all to prevent post operative sensitivity and discoloration of the tooth
  • Apply on the pulpal floor under zinc phosphate cement to prevent acid penetration
25
Q

What are the contraindications of varnish sealer

A
  • No thermal protection provided
  • Can’t be used under GIC as it prevents their adhesiveness to the tooth
  • Can’t be used under resin restorations as the residual monomer will dissolve the varnish
  • H2O soluble
26
Q

Examples of adhesive bonding agents are

A

glass ionomers

resin luting cements

27
Q

What are the indications of using adhesive sealers

A
  • treat or prevent hypersensitivity
  • seal dentinal tubules
  • ideal for use under all indirect restorations
28
Q

What are liners

A

cement or resin coating of minimal thickness to achieve a physical barrier to bacteria and their by products and/or provide a therapeutic effect such as an antibacterial or pulpal anodyne effect

29
Q

what are the 4 different types of liners

A
  • Calcium hydroxide
  • Zinc oxide eugenol
  • glass ionomer (type III)
  • Flowable composite
30
Q

What are the functions of liners

A
  • thereupetic benefits
  • fluoride release
  • antibacterial action to promote pulpal health
31
Q

calcium hydroxide is (self/light) curing

A

both

32
Q

What are the advantages of calcium hydroxide

A
  • Causes dentin mineralization by activating the enzyme ATPase
  • Stimulates reparative dentin formation
  • Biocompatibility
  • High pH (12.5), neutralizes acidity which in turn is bactericidal
33
Q

What are the dis advantages of Calcium hydroxide

A
  • low strength
  • high solubility
  • dissolves rapidly
34
Q

(T/F) Calcium hydroxide is ONLY placed on dentin

A

t

35
Q

Where is Ca(OH)2 placed in the prep

A

over the deepest portion of the prep because it lacks strength

36
Q

The addition of a glass ionomer to Ca(OH)2 is often necessary why?

A

because it adds strength to allow the Ca(OH)2 to sustain the restoration

37
Q

There are 6 different types of glass ionomers- what type is a liner and base

A

type III

38
Q

Glass ionomer type III has a powder and liquid component- what are they

A
  • Powder= aluminum silicate glass

- Liquid= polyalkenote acid, light cure resin

39
Q

What are the advantages of glass ionomers as liners

A
  • adhesive to the tooth
  • anticariogenic
  • semi translucent color helps in esthetic restorations
  • fluoride release
40
Q

What are the disadvantages of glass ionomers as a liner

A
  • water sorption causes leakage and discoloration

- Low wear or abrasion resistance

41
Q

The composition of flowable composite is similar to regular composite, except that it

A

has a lower amount of fillers

42
Q

Since flowable has a reduced number of fillers, what does this do to alter its physical properties compared to fully filled composites

A
  • more fluid consistency
  • less strength
  • less stiffens
43
Q

What are bases

A

materials to replace missing dentin, used for bulk buildup and/or for blocking out undercuts in indirect preps

44
Q

The usual thickness for a base is

A

0.5-1 mm

45
Q

There are two types of bases low and high strength- list the high strength ones

A
  • Zinc phosphate
  • Zinc polycarboxilate
  • Glass ionomer (Type III)
  • Reinfored zinc oxide
46
Q

There are two types of bases low and high strength- list the low strength ones

A
  • Calcium hydroxide

- Zinc oxide Eugenol

47
Q

What are the functions of a base

A
  • chemical insulator
  • Thermal insulator at minimum 0.75 thickness
  • Provides mechanical support to the restoration by distributing stresses to the underlying dentin
48
Q

What is the oldest luting cement

A

zinc phosphate

49
Q

What are the advantages of Zinc phosphate

A
  • good mechanical properties

- thermal insulator

50
Q

What are the disadvantages of zinc phosphate

A
  • Doesn’t adhere to the tooth
  • Produces an exothermic creation at initial setting, which can damage the pulp
  • More opaque in color- not recommended for esthetic restorations
  • Dissolves in mouth
  • Acidic in nature
51
Q

There is a powder and liquid component to Reinforced Zinc Oxide Eugenol what are they

A
  • Powder= zinc oxide and natural or synthetic resin

- Liquid= Eugenol, acetic acid, and thymol

52
Q

what are the properties of Reinforced Zinc Oxide Eugenol

A
  • Better strength than regular zinc oxide cement
  • less irritating to pulp
  • It has anodyne effect on the pulp
53
Q

what are the guidelines of the use of bases, liners, and sealers

A
  • Don’t remove sound tooth structure to provide space for bases
  • Maintaining the sound dentin will enhance restoration support and provide maximal pulp protection
  • Use base material for build up materials and block out materials for cementing indirect restorations
  • If bases are used under amalgam or resin then minimize the extent of the base
  • Use minimal thickness of liner necessary to achieve desired result
54
Q

Look at the chart on slide 40

A

ok

55
Q

Look at the videos on slide 41

A

ok

Direct/Cariology (20 decks)

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