WEEK 10 Flashcards
(49 cards)
When can a liner be placed?
for therapeutic reasons under deep caries.
exaplain seals the deal
once isolated from their source of nutrition by a restoration of sufficient integrity, bacteria in caries either die or remain dormant and therefore pose no risk to the tooth.
Why is the use of GIC linings no longer supported?
microgaps form between the dentin and GIC allowing bacteria infiltration, irritating the pulp.
Are calcium hydroxide linings soluble or insoluble?
soluble
Does calcium hydroxide chemically bind to dentin?
no
why do we need a liner of GIC over Calcium Hydroxide?
calcium hydroxide disintegrates under composite.
What are some reasons that post operative sensitivity can occur?
suboptimal operator technique (overdrying, excessive heat production from slow speed), or error in handling the adhesives and composites.
what is the one exception in which a liner can be placed?
for pulp protection and dentin remineralization. If the caries are close to the pulp, calcium hydroxide can be used to remineralize and promote healing. Covered with a coat of GIC.
What is another benefit to the GIC lining?
supports 2 step approach and re-entry.
What are caries?
An ecological inbalance in the biofilm composition and activity. There is a net mineral loss due to bacterial acid.
What is hard dentine? (SPECIFIC)
very resistant, requires a sharp instrument or bur to remove. Makes a scratchy or “cri-dentinaire” when probed.
What is firm dentine? (SPECIFIC)
resistant to hand excavation, needs moderate pressure to be removed.
What is leathery dentine? (SPECIFIC)
does not deform under pressure but can easily be removed with little force.
what is soft dentine? (SPECIFIC)
deforms easily under pressure and is effortlessly scooped out.
What is non-selective caries removal?
removal of all sodtened and demineralized dentin until only hard dentin remains at cavity edges and the near the pulp. No longer recommended.
What is selective removal to firm dentin?
carious tissue removed to hard dentin on the periphery and wide areas to esure a good seal of restoration. Removal stops at firm dentin in the pulpal area.
Which areas are selective removal to firm dentin used?
shallow to moderately deep lesions.
What is selective removal to soft dentin?
caries is removed to hard dentin in the peripheral areas, ensuring a strong seal and restoration longevity. In the pulpal areas, removal is limited to avoid pulp exposure. Leathery or soft dentin may be left intentionally.
where is selective removal to soft dentin used?
in deep lesions with vital, non-inflamed pulpal tissue.
what is the first step of step-wise removal?
first step is selective removal to soft dentin and a temporary restoration like GIC is placed. This promotes formation of reactionary dentin by odontoblasts, remineralization and drying of carious dentin, and inactivation of bacteria through sealing.
what is the second step of step wise removal?
After 6-12 months, re enter and perform selective removal to firm dentin, now safer due to the reduced bacterial load and thickened dentine.
When should you use the step wise technique?
If the caries is very deep, into 1/4 dentin, and you cannot gain moisture control.
When are non-removal strategies carried out?
non-cavitated lesions (white spot) bacteria can be sealed from nutrients. Use of sealants like GIC or RMGIC or halls crown on primary teeth.
What is non-restorative cavity control?
drill overhangs to make the area accessible, treat with fluoride to remineralize the tooth and slow caries progression. must be monitored.
