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.

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May Allah Bless On All of You.