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Carboxylate cement and pulp caps
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john kanca



Joined: 14 May 2005
Posts: 6346

PostPosted: Tue Mar 31, 2009 12:23 pm    Post subject: Carboxylate cement and pulp caps Reply with quote

Bulgarian Journal of Veterinary Medicine (2007), 10, No 1, 35−43
TISSUE RESPONSE OF DENTAL PULP IN DOGS
FOLLOWING DIRECT CAPPING WITH POTASSIUM
NITRATE IN POLYCARBOXYLATE CEMENT
I. BORISSOV1, S. TSANOVA3 & D. SIVREV2

Oral Surg Oral Med Oral Pathol. 1981 Feb;51(2):190-204.
Reaction of the exposed pulps to new cements containing calcium hydroxide.Negm MM, Combe EC, Grant AA.


Oral Surg Oral Med Oral Pathol. 1973 Jul;36(1):90-100.Links
Pulp capping in monkeys with a calcium-hydroxide compound, an antibiotic, and a polycarboxylate cement.McWalter GM, el-Kafrawy AH, Mitchell DF.

J Am Dent Assoc. 1976 Jul;93(1):105-10.Links
Long-term study of pulp capping in monkeys with three agents.McWalter GM, el-Kafrawy AH, Mitchell DF.


Carboxylate cement has one of the lowest pulp reactions ever seen.
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Pav



Joined: 10 Mar 2008
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PostPosted: Tue Mar 31, 2009 2:18 pm    Post subject: Reply with quote

What makes me laugh is you've been saying this for decades. Now people are preaching about it and claiming it as their own.

Funny how people come up with ground breaking ideas after your lectures
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john kanca



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PostPosted: Tue Mar 31, 2009 4:54 pm    Post subject: Reply with quote

Pav wrote:
What makes me laugh is you've been saying this for decades. Now people are preaching about it and claiming it as their own.

Funny how people come up with ground breaking ideas after your lectures


I always tried to attribute information to those from whom I learned it and you have heard me do so many times. I believe it is important to do so.
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Pav



Joined: 10 Mar 2008
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PostPosted: Wed Apr 01, 2009 12:28 am    Post subject: Reply with quote

Totally agree. Shame others don't have the same principles!
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john kanca



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PostPosted: Wed Apr 01, 2009 12:45 pm    Post subject: Reply with quote

If you're really serious about a liner to protect the pulp, carboxylate is the ONLY thing to use.
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JKesling



Joined: 24 Oct 2005
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PostPosted: Wed Apr 01, 2009 4:21 pm    Post subject: Reply with quote

Hi John,

Are you advocating the use of Duralon as a liner for deep preps?

Jeff
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couv4



Joined: 07 Apr 2009
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PostPosted: Wed Apr 15, 2009 11:15 am    Post subject: durelon as pulp cap Reply with quote

what is the ratio of powder to liquid that you use when doing a direct pulp cap. 1 to 1, 1 to 2. is the cap considered fixation or lining per instructions?

is there any benefit in putting the durelon in areas of deep decay or is a well placed (ie sealed) composite adequate to "arrest" the progression of the lesion? would the durelon be just an extra,wasted step? dr. melker per DT likes the antimicrobial effect of the durelon as his temporary cement, but this quality is only beneficial due to the "unsealed" nature of the temps, correct? due to the eventual breakdown of the seal would the durelon be an extra layer of defense or would the formation of tertiary dentin(?) by that time be protective enough to deter irreversible symptoms?


thanks
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john kanca



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PostPosted: Wed Apr 15, 2009 8:27 pm    Post subject: Re: durelon as pulp cap Reply with quote

couv4 wrote:
what is the ratio of powder to liquid that you use when doing a direct pulp cap. 1 to 1, 1 to 2. is the cap considered fixation or lining per instructions?

is there any benefit in putting the durelon in areas of deep decay or is a well placed (ie sealed) composite adequate to "arrest" the progression of the lesion? would the durelon be just an extra,wasted step? dr. melker per DT likes the antimicrobial effect of the durelon as his temporary cement, but this quality is only beneficial due to the "unsealed" nature of the temps, correct? due to the eventual breakdown of the seal would the durelon be an extra layer of defense or would the formation of tertiary dentin(?) by that time be protective enough to deter irreversible symptoms?


thanks


Durelon is not anti-microbial. Caries can be arrested with a well-sealed resin restoration. Literature has established that.

I cannot say with certainty what we use. I mix it to desired consistency- which is a little less viscous than normal ratios.

Today I used ZOP for a pulp cap.
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couv4



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PostPosted: Wed Apr 15, 2009 9:27 pm    Post subject: Reply with quote

why do you think that dr. melker states that it is antimicrobial. it seems that the protocol that dr. strupp/melker prescibe to is meticulous to say the least. is the durelon "coating" the dentin to such a degree that microbes are not "allowed" access that the antimicrobial belief comes into play.
i am not in any way trying to imply any "false info" but am just thinking as to why the durelon is temp cement of choice by these drs. if it was antimicrobial i could see why.
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Howardmg



Joined: 11 May 2005
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PostPosted: Thu Apr 16, 2009 10:32 am    Post subject: Reply with quote

Dr. Melkers and Strupp are not researchers.. They do what works well "in their hands". Now granted their hands are amazing so it is well worth listening to. But one also needs to take with a grain of salt when they get into scientific reasoning....
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john kanca



Joined: 14 May 2005
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PostPosted: Thu Apr 16, 2009 10:32 am    Post subject: Reply with quote

couv4 wrote:
why do you think that dr. melker states that it is antimicrobial. it seems that the protocol that dr. strupp/melker prescibe to is meticulous to say the least. is the durelon "coating" the dentin to such a degree that microbes are not "allowed" access that the antimicrobial belief comes into play.
i am not in any way trying to imply any "false info" but am just thinking as to why the durelon is temp cement of choice by these drs. if it was antimicrobial i could see why.


I cannot say. It is precisely because Durelon is not inherently anti-microbial that it never gained acceptance early on as a pulp cap, despite how really good it is at being one.

Sometimes people confuse what they want to believe with what is. I reproduced Strupp's protocol and saw no difference on bond strengths.
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couv4



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PostPosted: Thu Apr 16, 2009 8:42 pm    Post subject: Reply with quote

thanks for the reply.


clay
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JKesling



Joined: 24 Oct 2005
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PostPosted: Sat Apr 18, 2009 9:01 am    Post subject: Reply with quote

John,

Do you now prefer to use ZOP for pulp caps instead of Durelon?
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john kanca



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PostPosted: Sat Apr 18, 2009 7:21 pm    Post subject: Reply with quote

JKesling wrote:
John,

Do you now prefer to use ZOP for pulp caps instead of Durelon?


Not yet.
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ikke



Joined: 27 Apr 2010
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PostPosted: Sat Dec 18, 2010 10:16 am    Post subject: Reply with quote

Pav wrote:
What makes me laugh is you've been saying this for decades. Now people are preaching about it and claiming it as their own.


In the pyramid of evidence, there's lack of RCT or even case controls... So if they preach, they do it in silence. I'm not sayinh this stuff doesn't work, it does as I've seen in my practice...
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