Operative Dentistry
Y1B4,2007/08
Prepared by
Dr. Shawfekar
Cavity preparation is relationship with pulp.
Explain the protecting the pulp with cavity.
Describe the purpose of using cavity liners, list the
type of materials that can be used and explain the
placement procedure.
Describe the purpose of using cement base. List
types of materials and placement procedure.
Introduction.
Able to understand Pulp Protection Theory and
Cavity preparation /Pulp protection.
Describe the Practically in Treatment of Cavity
Preparation.
To recognize the Cavity Liners.
To recognize the Cavity Varnish.
To recognize the Cement Bases.
Should be familiar preparation of the cavity
with the amount of enamel and dentin
removed and how near the preparation is to
the pulp.
Should understand the pulp protection theory
that the depth of cavity preparations and
pulpal relation.
The cavity preparation for a restoration
depends on the amount of decay, the location
of the decay, and the type of materials used
to restore the tooth.
Should examine the cavity preparation to
assess pulpal involvement and then place the
liners, base, or varnish.
Treatment of the ideal cavity
preparation.
Treatment of the beyoung-ideal cavity
peparation
Treatment of the near-exposure cavity
preparation
Pulp Relation
A base is not required because only a minimal amount of
enamel and dentin has been removed.
Some dentists place only the restoration, while other prefer to
place a fluoride-releasing liner
If an amalgam restoration is going to be placed, two thin
layers of cavity vernish are often placed over the dentin.
If a composite restoration is going to be used, a glass
ionomer liner or calcium hydroxide is placed over the
exposed dentin.
With a beyond-ideal preparation, the level of
the dentin is restored with a cement base.
With an amalgam restoration, there are
several options. One option is to place two
thin layers of varnish to seal the dentin
tubules and then place a layer of a cement
base, such as zinc phosphate.
Another option is a reinforced ZOE
base, which has a soothing effect on
the pulp. Varnish is not used with this
material.
Other options include polycarboxylate
or glass ionomer base, which also do
not require varnish.
Under composite restorative materials,
use a glass ionmer base or calcium
hydroxide.
The closer the cavity preparation comes to
the pulp, the more precautions are needed.
There are also several options of treatment
of the near-exposure preparation.
Cavity which going to restore with
amalgam, a liner of calcium hydroxide,
glass ionomer, or ZOE is placed first, then a
layer of cement base such as Zinc
phosphate, polycarboxylate, or glass
ionomer cements.
Another option for amalgam restoration is
to place a liner, then a layer of reinforced
ZOE, polycarboxylate, or glass ionomer
cement. This is then sealed with cavity
varnish, although some dentist do not
place cavity varnish.
Restore with composite, a liner is placed
first, then place a layer of either
polycarboxylate or glass ionomer cement.
A cavity liner is placed on a near
exposure, the procedure isoften referred
to as an indirect pulp capping.
In an exposed pulp, should be decided
whether endodontic treatment is indicated or
should save the vitality of the tooth. If the
treatment of choice is to save the pulp, a
procedure called a direct pulp capping is
performed.
On this direct pulp capping treatment,
place the calcium hydroxide or glass
ionomer liner and then reinforced ZOE
as a temporary restoration. This gives
the dentist time to see whether the
pulp is going to heal.
Another treatment involves the
placement of a liner, a layer of ZOE
cement, two thin layers of varnish, and
cement base.
Some dentist prefer to place a liner
and then a layer of polycarboxylate or
glass ionomer cement base.
Cavity liners are placed in the deepest
portion of the cavity preparation on the
axial walls or pulpal walls.
When the liners are hardened, they form as
a cement layer with minimum strength.
Liners are protect the pulp from chemical
irritations and also provide a therapeutic
effect to the tooth.
Liners are calcium hydroxide, zinc oxide
eugenol, and glass ionomer.
Liners also called low-strength base.
Figure-1
Placing liner
Cavity varnish is used to seal the dentin tubules to
prevent acids, saliva and debris from the pulp.
It is used under amalgam restorations to prevent
microleakage and under zinc phosphate cement to
prevent penetration of acids to the pulp.
If cavity liners or medicated based are used,
varnish is placed after or on top of these materials.
Figure-2
Placing
varnish
Cement bases are mixed to a thick putty
consistency and placed in the cavity to
protect the pulp and provide mechnical
support for the restorstion
These cement bases are placed on the floor
of the cavity
Cement bases are glass ionomesr, hybrid
ionomers, reinforced zinc oxide,
Figure-2
Placing
Cement
bases
Phinney DJ, Halstead JH, 2000 Delmar’s
Dental Assisting, Delmar Thomson Learing.
Thank you,
May Allah Bless On All of You.