Introduction
History
Bleaching agent
Classification of Bleaching technique.
Vital bleaching technique
Effect of vital bleaching on tooth structure
Effect of vital bleaching on tetracycline stain
Effect of vital bleaching on Fluorosis stain
Effect of vital bleaching on restorative material
Conclusion
References
Introduction
History
Bleaching agent
Classification of Bleaching technique.
Vital bleaching technique
Effect of vital bleaching on tooth structure
Effect of vital bleaching on tetracycline stain
Effect of vital bleaching on Fluorosis stain
Effect of vital bleaching on restorative material
Conclusion
References
Pediatric Endodontics - Indirect and Direct pulp capping,Pulpotomy, Pulpecto...Karishma Sirimulla
this seminar consists of basis differences in root canal pattern between primary and permanet teeth followed by various definitions techniques and medicaments used in indirect pulp capping, direct pulp capping, pulpotomy, pulpectomy, apexogenesis and apexification
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Upper anterior teeth veneers (Laminates)Venkat Nag
if your teeth are discoloured, attrited or even malformed, veneers (laminates) can camouflage anything. it uses composite or porcelain and forms a tooth coloured layer on the tooth surface.
This presentation is intended to give the GP dentists as well as specialists some essential information regarding " white spot lesions" ,which can be considered as one of the most common side effect of orthodontic treatment with fixed appliances.
With all of the new innovations for dental cosmetics, dental veneers created hope for those who wanted to have instantly perfect teeth. Dental veneers provide new appearance to your teeth’s shape, color and length. They are bonded onto the surface to cover the unsightly appearance of your permanent teeth. There are two kinds of dental veneers, the porcelain and the resin. In just 2 visits, you can have the smile you always wanted.
A ceramic veneer is a thin shell custom that is made to fit on the tooth.
some of the benefits of a ceramic veneer:
It is strong and long-lasting
It's smooth, translucent surface provides a natural appearance
It doesn't stain easily
Pediatric Endodontics - Indirect and Direct pulp capping,Pulpotomy, Pulpecto...Karishma Sirimulla
this seminar consists of basis differences in root canal pattern between primary and permanet teeth followed by various definitions techniques and medicaments used in indirect pulp capping, direct pulp capping, pulpotomy, pulpectomy, apexogenesis and apexification
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Upper anterior teeth veneers (Laminates)Venkat Nag
if your teeth are discoloured, attrited or even malformed, veneers (laminates) can camouflage anything. it uses composite or porcelain and forms a tooth coloured layer on the tooth surface.
This presentation is intended to give the GP dentists as well as specialists some essential information regarding " white spot lesions" ,which can be considered as one of the most common side effect of orthodontic treatment with fixed appliances.
With all of the new innovations for dental cosmetics, dental veneers created hope for those who wanted to have instantly perfect teeth. Dental veneers provide new appearance to your teeth’s shape, color and length. They are bonded onto the surface to cover the unsightly appearance of your permanent teeth. There are two kinds of dental veneers, the porcelain and the resin. In just 2 visits, you can have the smile you always wanted.
A ceramic veneer is a thin shell custom that is made to fit on the tooth.
some of the benefits of a ceramic veneer:
It is strong and long-lasting
It's smooth, translucent surface provides a natural appearance
It doesn't stain easily
Mercury from restorations constitutes the largest non occupational source of mercury in the general population, being greater than all environmental sources combined
The pulp is the formative organ of the tooth.
The pulp has been described as highly resistant organ and as organ with little resistance or recuperating ability.
Its resistance depends on cellular activity, nutritional supply, age and other metabolic and physiologic parame
1 effect of different bleaching materials on color of stained resinAmeer Al-Ameedee
In this work, ZnO, and TiO
2
(Hombikat UV 100) and TiO2 doped with 0.5 % of Pt, and Pd metals, that
prepared by photo deposition method. The bare TiO
2
and prepared samples were characterized by powder
X-ray diffraction (XRD), UV–vis diffuse reflectance spectra (UV–vis DRS), nitrogen adsorption BET, and
atomic force microscopy (AFM) were evaluate the effect of photochemical activation by kinds of
semiconductors (ZnO, TiO2, Pt/TiO2, and Pd/TiO2) in bleaching gels with UV-light type A, with the
purpose of accelerating the process of pigmented component oxidation on Filtek Z350XT resin composite
(3M ESPE).The bare catalysts and metal doped prepared where testing by taken twenty-five disc-shaped of
the Filtek Z350XT resin composite specimens (3M ESPE) were used in this study, then immersion in tea
staining solutions, after that they were randomly divided into five groups specimens (each group n = 10)
according to the type of whitening chemical materials treatment applied(ZnO, Pt/TiO
2
, TiO
2
, Pd/TiO2 and
TiO2/UV 100). The color measurements were taken: at baseline, after immersion and after chemical
treatment procedures by using a stereomicroscope (vita easy shade device). The results recorded,
tabulated and statwastically analyses.The results showed the highest mean color difference ∆E values
were: group two Pt/TiO2, group three TiO2, group five TiO2 / UV 100, Pd/TiO2 and group one ZnO
respectively. However, there was no statistically significant difference in-group three TiO
2.
In addition, a
whitening effect was demonstrated with group two Pt/TiO
2
and group five TiO
2
/ UV 100 showed
statistically significant lowest in a* color space compared to others groups. In addition, results show
immersion tea staining solutions had a positive influence on the color changes of resin composite.
Effect of aqueous suspensions of titanium dioxide in photoreactor withAmeer Al-Ameedee
The study performed to assess the effect of titanium dioxide using (Photoreactor) with the source of radiation on the color change of the
three contemporary dental fillings by composite resin material. The resins were divided into three groups head of considering the type of
charge and each group of which is composed of five discs and each disc thickness of 2 mm and diameter of 5 mm and manufactured by
the mold of Teflon material and then been refined and soften the disc surface and stored in distilled water for one week at 37 °C in order
to complete the polymerization. After the completion of the first week is staining the surface of disks and putting it in a solution of iodine
mouth wash (AVALON pharma
®
) at 37 °C for a period of just one week after the completion of this week has been directed drive and put
it in aqueous suspension consisting of titanium dioxide in Photoreactor Radiation with 355 NM periods of time 0, 5, 10, 15 and 30
seconds. Colorimetric readings were taken of the tablets based on, before staining substance iodine solution, after staining discs textured
iodine solution and after treatment disks Palmalq water for titanium dioxide. In addition, the absorbance was measured after each period
of time and put the disks. Palmalq watery results were analyzed statistically. There were significant effects on pay chromatography and the
palace of color where are different for each group from the other and come the second group of the most influential change chromatography
and minors chromatography and then finished second the third set. Finally, comes the first group, as well as influenced by absorbance
time in extrusive and different for each group of the three groups of disk attributed to their chemical composition
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Pulp:
1. Formative organ of tooth.
2. Builds primary dentin during development of tooth.
3. Secondary dentin after tooth eruption.
4. Reparative dentin in response to stimulation as long as odontoblast remain vital
3. Patient history:
•Has the tooth ever hurt (scale of 1-10).
•Does cold or hot bother the tooth.
•Does it hurt when you bite.
•Has the tooth been traumatized.
•Is your pain spontaneous.
•How long have the symptoms been present.
•Does the pain wake you up at night.
•What makes the pain better or worse.
Clinical exam:
•Radiographic.
•Decay.
•Soft tissue findings.
5. TYPES AND FEATURES OF PULPAL AND RELATED PAIN
1-Pulpitis:
Most common cause of dental pain, loss of teeth in younger persons, usual cause is caries penetrating the dentin.
Treatment; removal of irritants before the pulp is severely damaged.
2-Reversible pulpitis: Pain of short duration on response to hot, cold or sweet things, no apparent radiograpic
changes to periapical tissue. Not sensitive to percussion, relieved by analgesics, poor pain localization. Treatment –
Routine restorative.
3-Irreversible pulpitis:
Pain of long duration, often worse with hot stimuli, may be throbbing and dull in nature, better pain localization than
reversible pulpitis, no apparent radiographic changes, not sensitive to percussion, not always relieved by analgesics.
Initiate endo treatment (complete removal of pulp or pulpectomy, placement of intracanal medicament to act as
disinfectant or relief pain as cresatin, eugenol, formocresol).
VITAL PULPITIS
6. Periapical periodontitis:
Dull, throbbing, often constant pain; frequently kept awake, patient can usually localise pain to a particular tooth,
tender to chew on tooth, poor relief by analgesics.
NECROTIC PULP
1-Necrotic pulp with acute apical periodontitis:
May or may not have radiographic changes, discoloration of tooth, sensitive to percussion, may or may not have
thermal sensitivity, spontaneous pain, likely no response to electrical stimulus, treatment by endo.
2-Necrotic pulp with chronic periapical periodontitis:
Likely to see radiographic changes, discoloration of tooth, sensitive to percussion, no thermal sensitivity, no
response to electrical stimulus, may or may not have spontaneous pain. Treatment by endo.
7. HISTORY
Pain history is important in the diagnosis of pulpal pain. Important features are:
PAIN QUALITY
Sharpness Sharp pain can indicate, e.g. exposed dentinal tubules, fractured cusp. Dullness May indicate pulpal
hyperaemia. Throbbing Throbbing pain, particularly if constant, may indicate an irreversible pulpitis.
DURATION
Short (i.e. a few seconds) can indicate a reversible pulpitis but may indicate pain of non-dental origin, e.g. trigeminal
neuralgia (p. 427).
Constant Often indicates irreversible pulpitis or one of its sequelae.
STIMULI
1. Reaction to heat Often irreversible pulpitis if reacts to heat but not cold.
2. Reaction to cold Often reversible pulpitis, exposed dentine or cracked cusp. These conditions also often react to heat.
3. Reaction to pressure May indicate periapical or periodontal abscess. Reaction to release of pressure may indicate a
cracked cusp.
4. Reaction to sweet stimuli Frequent occurrence in reversible pulpitis.
8. SITE AND RADIATION
History should indicate the primary site of pain and where it radiates. Pain in teeth adjacent to the tooth the patient
suspects as the cause of pain or opposing arch is common. Referred pain from non-dental causes (e.g. sinusitis) should be
borne in mind. Pain localization is particularly difficult in low-grade reversible pulpitis and in children.
TIMING
Pain pattern day and night is important. Pulpal pain is often worse at night. A pain history gives the dentist a guide as to
the source of pulpal pain. It does not produce a diagnosis on its own.
9. CLINICAL EXAMINATION
In dealing with pulpal pain, the examination should be conducted as follows:
VISUAL
Look for: • obvious cavities • cracked cusps • fractured restorations • swelling • sinus tracts.
PROBING
To aid visual examination.
PERCUSSION
When coupled with pain history, tenderness on percussion is an important feature of irreversible pulpitis, periapical
periodontitis and periapical abscess. Percussion should be in an apical and lateral direction and several ‘control’ teeth
should be percussed to check responses.
10. SPECIAL TESTS Special tests are extremely useful in confirming suspicions from a
pain history and examination.
SENSIBILITY (VITALITY) TESTING
Use heat, cold, electric stimuli. Important to use ‘control’ teeth. May indicate normal, exaggerated or no response to stimulus.
LASER DOPPLER
Measures pulpal blood flow and gives an indication of pulpal vitality.
11. RADIOGRAPHS
Periapical radiographs Indicate bony change apically, although they also show proximity of restorations/caries to
the pulp and may give an indication of previous indirect or direct pulp capping. Bitewing radiographs Also indicate
proximity of restorations/ caries to the pulp. Multirooted teeth may need two or more radiographs at different
angles to show problems.
TRANSILLUMINATION
May indicate caries mesially or distally on anterior teeth.
TOOTH ‘SLOOTH’
Aid to localising cracked cusps.
12. To the inexperienced dentist, pain history and examination may be extremely confusing and resultant diagnosis
difficult. This is particularly true when:
The mouth is heavily restored
Multiple crowns, endodontically treated teeth, etc. may ‘hide’ the diagnosis. Less radio-opaque restorative materials
make radiographic diagnosis of caries difficult.
Multiple pathology In a neglected mouth multiple problems may be apparent, making it difficult to localise the source
of an individual’s pain at a particular time.
Non-organic pain Symptoms of atypical facial pain may be confused with pulpal pain.
Dual pathology Where symptoms are arising from more than one tooth simultaneously.
Anxious patient May be withdrawn. Can be difficult to obtain a satisfactory history. Additionally there may be
exaggerated responses to examination.
PROBLEMS IN DIAGNOSING PULPAL PAIN
In the diagnosis of pulpal pain, intervene only on the evidence of more than one symptom or sign. If unsure of the
diagnosis in a particular case, more evidence should be gathered by further special tests or repeating history or
examination. Irreversible dental treatment should not be embarked upon until the diagnosis is established.
13. MANAGEMENT OF THE DEEP CARIOUS LESION
A deep carious lesion occurs when the caries lies in close proximity to the dental pulp. When a cavity is considered
deep but the pulp is not exposed, hard stained dentine may be left over the pulpal area. Removal of this frequently
results in pulpal exposure.
14. MANAGEMENT OF THE DEEP CARIOUS LESION
A deep carious lesion occurs when the caries lies in close proximity to the dental pulp.
INDIRECT PULP CAPPING:
The object of this technique is to protect the pulp from bacterial contamination via a pulpal exposure. A pulpal
exposure is recognized by pulpal hemorrhage. It must be noted that a micro exposure may be present. Therefore
the classical bleeding exposure is a relatively severe pulpal wound. Deep cavities should be managed under rubber
dam to decrease bacterial contamination of micro exposures, pulpal exposures or carious exposures (p. 150).
Technique:
Indirect pulp capping should be used for all cavities where it is considered there may be a micro-exposure or where
removing further remnants of caries is likely to cause classic pulpal exposure. A layer of calcium hydroxide (setting)
is placed over the dentine closest to the micro exposure. This is reinforced by a structural lining.
TECHNIQUES FOR MANAGEMENT OF THE DEEP CARIOUS LESION
15.
16. DIRECT PULP CAPPING:
An exposed vital pulp may be pulp capped. Less successful than indirect pulp capping.
Direct pulp capping is most likely to succeed when:
1. Pulpal exposure is small, i.e. small pinpoint.
2. Pulp is free of salivary contamination.
3. Carious exposure is not present (pulp already likely to be chronically inflamed).
4. Tooth was symptom free prior to cavity preparation (less initial pulpal inflammation).
5. patient is young (better pulpal blood supply).
Technique:
Haemorrhage is arrested with a sterile paper point or cotton-wool ball. Cavity cleaned with sterile saline. Calcium
hydroxide flowed over exposure and allowed to set. Structural lining placed.
17. Mode of action of calcium hydroxide in pulp capping
Calcium hydroxide has several actions in pulp capping:
Antibacterial action:
Demineralization and staining precedes bacterial invasion of dentine. Calcium hydroxide can render this
demineralized dentine sterile via its inherent antibacterial activity due to its high pH, although quickly neutralized.
Remineralisation:
Calcium hydroxide may be involved in the remineralization of carious dentine. This is not fully understood.
Reparative dentine formation:
In the pulpal tissue adjacent to calcium hydroxide there is a zone of necrosis followed by repair, by formation of
intertubular or intratubular mineralization of dentine, or by the formation of a tubular dentine.
18.
19.
20. A carious exposure means that the exposed pulp is contaminated with bacteria and essentially undergoing a chronic
inflammatory process. The treatment of choice for a carious exposure is removal of the pulp and conventional root
canal treatment.
Use of corticosteroid–antibiotic:
Preparations in management of the deep carious lesion Corticosteroid–antibiotic pastes have been used for many
years to relieve acute pain associated with deep carious lesions.
Mode of action Anti-inflammatory:
(from the steroid) and antibacterial (from the antibiotic). Useful when there is a hyperaemic pulp and failure of local
anaesthesia; most commonly when there is an irreversible pulpitis and/or carious exposure. Use of these pastes may
cause relief of symptoms, decreased inflammation with ability to successfully anaesthetise the tooth on the next
occasion.
Haemorrhage is arrested with a sterile paper point or cotton-wool ball. Cavity cleaned with sterile saline. Calcium
hydroxide flowed over exposure and allowed to set. Structural lining placed.
CARIOUS EXPOSURES
21. MANAGEMENT OF REMAINING CARIES:
Caries will be removed by preparation of outline, resistance and retention form. Usually there will be some caries left
after this has been performed. Removal of existing caries should be undertaken with the following principles in mind:
1. The cavity margin must be caries free.
2. Great care should be taken to remove all caries and stained dentine from the amelodentinal junction.
3. Stained but hard dentine may be left in the deepest parts of the cavity.
4. Soft dentine should be removed.
ENAMEL MARGIN FINISHING:
In most cavities the cavosurface angle (solid-line angle between cavity wall and tooth surface) should be 90º. Cavity
margins should be closely inspected and gross unsupported enamel removed. However, the marginal strength of the
restorative material for a particular cavity is a factor in determining the best cavo-surface angle and the amount of
unsupported enamel to be removed.