PULP - LININGS 2

PULP - LININGS 2

1. WHAT USE - WHERE AND WHEN

2. Cavities of 2mm or less - no lining

3. slightly deeper than 2mm - lining to be used

4. WHERE TO USE

   • Pulpal -axial wall and or occ floor
   • ie areas directly overlying the pulp

5. 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

6. 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

7. 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

8. 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