PULP PROTECTION & RESTORATION
FRANCIS OCHENG
PULP PROTECTION
INTRODUCTION
DENTAL PULP
At the core of the tooth
Form bulk of the tooth during development
Continues to produce dentine throughout life
PULP PROTECTION
DENTAL PULP
Has odontoblast, which project into dentinal tubules
Tubules are usually patent up to the amelo-dentinal
junction
PULP PROTECTION
DENTAL PULP
All tubules end lead up
to the pulp
The more tubules are
involved in disease, the
greater the potential for
pulp damage
PULP PROTECTION
DENTAL PULP
The more tubules are
involved in disease, the
greater the potential for
pulp damage
PULP PROTECTION
DENTAL PULP
Condition of the pulp may classified as:
Normal pulp
Reversible pulpitis
Irreversible pulpitis
Pulp necrosis
PULP PROTECTION
DENTAL PULP
Pulp assessment
Important before cavity preparation
Can be done through
History
Clinical examination
Special test;
Electric current
Application of cold
Application of heat
Radiograph
Cavity preparation without anaesthesia
PULP PROTECTION
DENTAL PULP
Intermediate restorative materials have been
developed to be applied to the dentine prior to
the placement of the permanent restorative
material.
Their role may be;
Protective
Thermal
Chemicals
Bacteria/endotoxins
Palliative
Therapeutic
PULP PROTECTION
DENTAL PULP
Intermediate restorative materials
Cavity varnish
Liners
Bases
PULP PROTECTION
Cavity varnish, Liners and Bases
Selection of material is influenced by proximity of
the cavity to the pulp
Should not confused with temporary restorative
material
PULP PROTECTION
Minimal depth cavities
Cavities should be
prepared only to a
depth sufficient to
provide adequate depth
of amalgam
Dentine should never be
removed unnecessarily
to create space for a
lining material (there is
sufficient dentine to act
as a insulator).
PULP PROTECTION
Minimal depth cavities
Lining should not be placed in the cavity in such
bulk that the amalgam will be thin in section.
Make amalgam prone to fracture
PULP PROTECTION
Minimal depth cavities
Pulp requires protection only from fluid movement
down dentinal tubules arising from occlusal
pressure, thermal expansion of metal and from
ingres of bacteria down the dentinal tubules
PULP PROTECTION
Minimal depth cavities
Most common method of pulp protection
Cavity varnish
Thin layer applied over the whole of dentine
Effectively seals dentinal tubules
Prevent fluid movement
Reduce potential for microleakage
PULP PROTECTION
Moderately deep dentine caries
There is possibility of direct thermal stimulus
to the pulp.
Any inflammation of the pulp will subside if
irritating stimulus (i.e bacteria, toxins in
caries is removed)
No need to encourage growth of
reparative dentine
PULP PROTECTION
Moderately deep dentine caries
Method of pulp protection
Modified zinc oxide eugenol
IRM (intermediate restorative material)
EBA (Ethoxybenzoic acid)
Zinc phosphate
Polycarboxylate cement
Glass ionomer.
PULP PROTECTION
Moderately deep dentine caries/cavities
Method of pulp protection
Eugenol
has palliative (obtundant) effect on infamed pulp
Kill bacteria in the cavity
Cavity varnish is still applied because not all exposed
dentine is covered by lining material.
PULP PROTECTION
Deep caries/cavities
Calcium hydroxide first placed in the deepest part
of the cavity
Encourage formation of reparative dentine
Modified zinc oxide then placed over Calcium
hydroxide
Cavity varnish
PULP PROTECTION
Summary
Restoration-Clinical steps
Minimum depth cavity
Clinical steps
Dental amalgamator is used in dentistry for the
blending of restorative materials such as silver
amalgam capsules and glass ionomer
A modern amalgamator is a computerized
mixing system that works under the control of a
microprocessor. This ensures a precise, controlled,
and consistent mix.
The main components of an amalgamator are a
series electric motor and a holder for receiving
the capsule with the materials to be mixed for
providing the filling compound
The typical amalgamator is designed to hold the
ends of the capsule in a claw that is oscillating in
a figure-of-eight pattern. The design accelerates
the mixture towards each end of the capsule
during each throw and impacts the mixture with
the pestle. Amalgamators are used to form
amalgam used for the filling of prepared
Clinical steps
Amalgam well is designed for
easy amalgam
Amalgam carriers are
instruments used to fill the
dental cavities with amalgam.
They act like syringes, carrying in
their tubular tip the amalgam
which is inserted and pressed in
the dental cavity by pressing on
the lever which activates the
piston inside the tube or the
back end of the amalgam
carrier
Acknowledgment
Iraq dental academy