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Carboxylate cement and pulp caps
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ikke



Joined: 27 Apr 2010
Posts: 100

PostPosted: Wed Dec 22, 2010 2:08 pm    Post subject: Reply with quote

OK, next time I'll shut up... Posting this before someone else humiliates me... (Assuming Durelon contains KNO3)
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http://www.ncbi.nlm.nih.gov/pubmed/16353032
Stomatologiia (Mosk). 2005;84(6):28-32.
[Clinical results of potassium nitrate use in polycarboxylate cement for biological treatment of reversible pulpitis].

To determine effectiveness of indirect pulp capping with 5% potassium nitrate in polycarboxylate cement for biological treatment of reversible pulpitis, a clinical study of 232 teeth with active caries lesions from 205 healthy patients aged from 16 to 40 years was performed. They were divided into 2 groups: the study group--140 teeth of 127 persons with 5% potassium nitrate in polycarboxylate cement (Carboxy Adhesor); control group--92 teeth of 78 persons with calcium-hydroxide cement (Dycal). Short-term clinical results showed better desensitizing effect and faster recovery to normal values of electric vitality in teeth treated by potassium nitrate in comparison with Dycal lining (p<0.001). Long-term follow-up (up to 2 years) showed good functional conditions, preserved vitality and x-ray status of the treated teeth.
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http://www.ncbi.nlm.nih.gov/pubmed/15272814

Early clinical results from the use of 5% potassium nitrate in polycarboxylate cement for biological treatment of reversible pulpitis.

Tsanova STs.

Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Medical University, Plovdiv.
Abstract

The aim of the present study was to obtain immediate and early clinical results from the use of 5% potassium nitrate (KNO3) in polycarboxylate cement for biological treatment of reversible pulpitis.

MATERIAL AND METHODS: The method was applied in 140 teeth, mostly premolars and molars, with a clinical diagnosis of reversible pulpitis and indications for biological treatment of the inflamed dental pulp by means of indirect pulp capping. All teeth had clinically healthy periodontium and no non-carious lesions of the hard dental tissues. The study sample consisted of 127 patients aged between 16 and 40 years. The control group included 92 teeth in 78 patients, which were treated by a calcium hydroxide liner. The follow-up examinations were conducted 24 hours after treatment and on day 3 for the immediate results, and on days 7, 14, 30, and 90 for the early clinical results assessing the functional condition of the teeth, presence of thermal stimulus-induced pain and the measurements from the electric pulp vitality tests. The results were analysed with the analysis of variance and graphic analysis.

RESULTS: The immediate and early clinical results of the biological treatment of reversible pulpitis with 5% KNO3 in polycarboxylate cement show that pain as a symptom of the initial inflammatory process in the dental pulp is rapidly and effectively relieved, leaving the treated teeth in good functional condition. The comparison of the measurements from the electric pulp tests of all teeth reveals a statistically significant difference (u = 8.51; P < 0.001) in favour of the group treated with potassium nitrate and polycarboxylate cement.

CONCLUSIONS: 1. The immediate and early clinical results of our study suggest that treating reversible pulpitis with 5% KNO3 in polycarboxylate cement has an a very good analgesic action 2. The normal electrical excitability of the treated teeth is restored faster than that in the teeth treated by calcium hydroxide-based materials (P < 0.001).
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john kanca



Joined: 14 May 2005
Posts: 6346

PostPosted: Wed Dec 22, 2010 8:03 pm    Post subject: Reply with quote

It normally doesn't but....

Oral Surg Oral Med Oral Pathol. 1978 Jan;45(1):123-30.

The effect of zinc phosphate and carboxylate cements on the healing of experimentally induced pulpitis.
Lervik T.

Abstract
The effects of zinc phosphate and carboxylate cements on the healing of experimentally induced pulpitis have been studied. The results demonstrate that both cements allow healing of pulp imflammation when used as base materials.
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ilikecoffee



Joined: 02 Mar 2010
Posts: 123

PostPosted: Thu Jun 02, 2011 6:23 pm    Post subject: Reply with quote

The auto mix durelon caps should be replaced with a small auto mix using an endo long tip for this usage. This would allow more accurate placement of a smaller amount. Has anyone been able to adapt a smaller thinner tip to the caps?
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john kanca



Joined: 14 May 2005
Posts: 6346

PostPosted: Fri Jun 03, 2011 7:37 am    Post subject: Reply with quote

Not sure if I posted this already, but here goes:


Quote:
Dr. Kanca

I will get straight to the point. After 30 years in a boutique part time practice while raising my kids, I am now working as the sole provider for 1600 inmates at ************** here in northeast Ohio.

This is a minimum security facility, and the majority of my patients are between the ages of 19 and 30. Rampant decay, either drug induced or lifetime neglect induced is common here. For many of these guys, I am their first dental experience.

My most recent lecture notes from you stated that carboxylate cements (Duralon equivilent) is the best pulp cap material. My current MO is to excavate quadrants or full arches of decay under local anesthetic, then place carboxylate cement into the deepest areas or onto pinpoint exposures. This cement takes a frustratingly long time to set up, but I have nothing else to go on besides your lecture notes. I am not willing to go by a dental manufacturer's advertising in choosing a product. I then go through and use either glass ionomer or RRGI to stabilzie the teeth.

So far, the success rate has been surprisingly high. My question: Am I up to date on the data, and using the best products to preserve pulp health? The stakes are high here, as a failed pulp usually results in an extraction.

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