Professional Documents
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Treatment
The current operative
tradition
Nevertheless, current clinical practice is
immediately to perform operative
intervention in order to:
• remove softened, infected carious
dentin (because, according to present
paradigms, the infected tissue should
be eliminated until dentin that is hard
to touch has been obtained)
• extend the removal of enamel and
dentin to obtain a cavity suitable
for insertion of the restorative
material of choice
• apply some agents /protective materials ,
e.g. calcium hydroxide to protect the
pulpo-dentinal complex from:
– toxic effects of restorative materials
– microorganisms penetrating owing
to leakage at the tooth–restoration
interface
– thermal fluctuations.
Treatment
The results of diagnosis :
stepwise
excavation
Eliminating Promoting
cariogenic tertiary
bacteria dentin
Direct Pulp Capping
Technique for treating a pulp
exposure with a material that
seals over the exposure site &
promotes reparative dentin
formation..
Requirements of direct pulp
capping:
Asymptomatic vital tooth
Pin-point exposure (0.5mm or
less in diameter)
Non-hemorrhagic or easily
controlled.
Dry, sterile filed
Non-carious atraumatic
exposure
Technique:
1. Bleeding must be controlled.
This control may be achieved by :
Washing the area with sterile saline and drying
it with either paper points or cotton pellets,
Using cotton pellets soaked with hydrogen
peroxide or 5.25% sodium hypochlorite, OR
Using a hemostatic agent .
If bleeding fails to stop after two or three
attempts, then endodontic therapy should be
considered.
Biodentin TM
(calcium silicate – based restorative
cement)
Minimal Invasive in Caries Removal
air abrasion
Lasers
polymer burs
chemo-mechanical caries removal (carisolv
gel, caries detector dyes)
ozone
Air Abrasion
Lasers
Polymer Burs
Chemo-mechanical caries removal
chemo-mechanical caries removal method for
minimally invasive caries removal .
The lesion is gently scraped with Re-applied gel stays clear. Cavity
a star instrument is hard with a probe.
The gel is removed with a
Complete caries removal is
dry pellet
checked with an explorer