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Simplicity and Pulp capping
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cool kid



Joined: 12 May 2005
Posts: 818
Location: chicago

PostPosted: Tue Oct 11, 2005 8:54 am    Post subject: Reply with quote

thanks marshall, that is the answer I was hoping for.
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Rich (cool kid) Rosenblatt
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Gerry



Joined: 13 May 2005
Posts: 448
Location: Tarrytown NY

PostPosted: Tue Oct 11, 2005 9:05 am    Post subject: Reply with quote

Well done Marshall!

Of course experience and subjective determination is still is an important factor in removing cariously envolved dentin.

However T. Fusayama developed caries disclosing solutions to differentiate between the two layers of carious dentin - outer/INfected and inner/AFfected dentin by degree of coloration. (J Dent Res 1972 51:866; Oper Dent 1979 4:63-70) In an attempt avoid any subjectivity in the determination of how much material to remove when restoring cariously envolved teeth some methods other than "Well that seems OK" should be available. I have used SmartPrep burs since their inception and am somewhat satisfied with the results.

I still feel strongly that the use of caries disclosing in conjunctin with SmartPrep burs gives the DDS has the best shot at avoiding over-preparation of teeth with carious lesions.
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Gerry



Joined: 13 May 2005
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Location: Tarrytown NY

PostPosted: Tue Oct 11, 2005 9:14 am    Post subject: Reply with quote

I've been checking some of the research concerning the ability of various adhesives to actually bond to affected dentin. It seem this is matierial selective as well as tooth dependant. Perhaps we can figure out some research with Simplicity. It seems to work perfectly in my practice!

As far as Polycarboxylate cements for pulp capping - Great results. However, it takes forever to set and there is no light cured version of the stuff. If anyone has a suggestion for something that sets in a reasonable time PLEASE let me know!!
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Ekrause



Joined: 11 May 2005
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PostPosted: Tue Oct 11, 2005 12:09 pm    Post subject: Reply with quote

add a drop of water and it will set quite rapidly.
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Gerry



Joined: 13 May 2005
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Location: Tarrytown NY

PostPosted: Tue Oct 11, 2005 12:14 pm    Post subject: Reply with quote

Tried H20 in the polycarb we have in the office. Didn't do much if anything except make it weaker and runnier. What brand do you suggest?
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Ekrause



Joined: 11 May 2005
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PostPosted: Tue Oct 11, 2005 12:21 pm    Post subject: Reply with quote

Durelon.

Mix it to the same thickness as previously. Use a little less liquid and a small drop of water, more powder if necessary.
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john kanca



Joined: 14 May 2005
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PostPosted: Tue Oct 11, 2005 12:24 pm    Post subject: Reply with quote

Gerry wrote:
Tried H20 in the polycarb we have in the office. Didn't do much if anything except make it weaker and runnier. What brand do you suggest?


Stop using cheap brands! Razz

We're working on it.
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Gerry



Joined: 13 May 2005
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Location: Tarrytown NY

PostPosted: Tue Oct 11, 2005 12:26 pm    Post subject: Reply with quote

Cement I use may be crummy but it ain't cheap!

I'll try the reduced liquid thing. THANKS!!
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spruster



Joined: 28 May 2005
Posts: 23
Location: akron,ohio

PostPosted: Thu Jan 05, 2006 11:16 am    Post subject: Reply with quote

just cemented another cerec over a direct pulp cap from carious exposure . this one looked perfect with zero bleeding. crossing my fingers. zero symptoms prior to tx so i went for it. i'll keep you posted.
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spruce
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spruster



Joined: 28 May 2005
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Location: akron,ohio

PostPosted: Sun Jan 08, 2006 3:23 pm    Post subject: Reply with quote

Crying or Very sad .

this one was completely stable and clean. no hint of bleeding. about a 1mm exposure. i am very meticulous so i thought i covered all the bases.

endo followed the next day.
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spruce
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cool kid



Joined: 12 May 2005
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PostPosted: Sun Jan 08, 2006 5:18 pm    Post subject: Reply with quote

happens to all of us bruce!
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john kanca



Joined: 14 May 2005
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PostPosted: Sun Jan 08, 2006 6:05 pm    Post subject: Reply with quote

spruster wrote:
Crying or Very sad .

this one was completely stable and clean. no hint of bleeding. about a 1mm exposure. i am very meticulous so i thought i covered all the bases.

endo followed the next day.


OK, next time try not exposing it. Smile

It still might not work but the chances would be better.
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spruster



Joined: 28 May 2005
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Location: akron,ohio

PostPosted: Sat Jan 14, 2006 5:53 pm    Post subject: Reply with quote

john, i think part of the problem is missed protocol. i stemmed bleeding with diluted bleach. but out of habit i used etoh and figured that lowered my odds. i just read your new protocol and will use that for now on. i am going to sequester next time.

i'm also going to consider a move to 6.0 dfv instead of the 4.0 orascoptics i use now.
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spruce
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jrgeaman



Joined: 28 May 2005
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PostPosted: Sun Jan 22, 2006 2:59 pm    Post subject: Simplicity and Pulp Capping Reply with quote

I remember well from a previous thread that John advocated doing all one can to leave the last remaining caries over the pulp without a direct pulp exposure. Then go through your protocol of disinfecting/sterilizing and consider the treatment an indirect pulp cap. Your best chance for success is directly over the pulp horn.
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cool kid



Joined: 12 May 2005
Posts: 818
Location: chicago

PostPosted: Tue Mar 20, 2007 8:52 am    Post subject: Reply with quote

This thread really came in handy yesterday. I had a pt where I was removing a crown on #3 with failing margins and recurrent decay. I was removing all the old build up material when all of a sudden WHAM......mechaincal exposure. It is small(pinpoint) but bleeding. I get out the NaOCl on a cotton pellet and get the bleeding stop. Put some durelon on it and then simplicity and titan over it. I went and finished my cerec. No call last night, but we shall see. Before this thread, I would have just started endo. I hope this works out, but was nice to know that I had the proper protocol at my finger tips. Great forum!!!!!!!!!
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