Pulp Protection Part II Flashcards
Define pulp capping
an endodontic treatment designed to maintain the vitality of the endodontium (or the pulp-dentin complex)
What factors for each patient must be considered for pulp capping
- tooth must have a vital pulp and no history of spontaneous pain
- pain elicited during pulp testing with a hot/cold stimulus shouldn’t linger when stimulus is removed
- PA X-ray should show no evidence of a periradicular lesion
- Bacteria must be excluded from a site by the restoration
Which forms more tertiary (reparative) dentin small/slowly progressive lesions or large/rapid progressing lesions
small/slow
Which forms more reactionary dentin, (old/young) teeth and why
young because the pulp is more vital.
What is tubular sclerosis
it is a defense reaction of the pulp- it is the process in which mineral is deposited within the dentinal tubules reducing the permeability to bacteria and toxins
what cells are responsible for secreting reactionary dentin
primary odontoblasts
when is reactionary dentin synthesized
then the pulp has been injured or in response to irritants (like caries and trauma)- but not so injured that the odontoblasts don’t survive
Describe the morphology of reactionary dentin
resembles primary dentin matrix and has a tubular pattern
Where does tertiary/ reparative dentin form
at the pulp-dentin interface
The distribution of tertiary dentin is limited to where
area beneath the stimulus
How does the tertiary dentin provide extra protection to the pulp
by increased the distance between them and injurious stimuli
What is direct pulp capping (DPC)
Procedure in which small exposure of the pulp occurs during cavity preparation or injury (due to caries) with a sound surrounding dentin, is dressed with an appropriate biocompatible radiopaque base in contact with the exposed pulp tissue prior to placing a final restoration
What are the objectives of DPC
- maintain the pulps vitality and function**
- Normal responsiveness to electrical and thermal pulp tests
- Formation of secondary/reparative dentin
- No prolonged post operative pain or swelling
- No pathological changes
What are the indications for direct pulp capping (DPC)
- light red bleeding from the exposure site that can be controlled by cotton
- Traumatic exposures in a dry, clean field, which are reported to dental clinic within 24 hrs
- Small pin-point exposure surrounded by sound dentin during mechanical prep of the cavity
Contraindications for DPC
- Systemic diseases (i.e diabetes and cancer)
- Primary teeth with root resorption
- Pre operative tooth sensitivity
- large pulp exposure
- X-ray changes
- Uncontrolled bleeding
- Non-restorable tooth or restorable with low prognosis
- Tooth mobility
- Swelling and fistula