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Questions and Answers
What is tertiary dentin characterized by?
What is the primary action of liners in deep cavities?
Which film thickness is typically associated with thick liners?
What is the typical film thickness produced by solution liners (varnishes)?
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What function do suspension liners primarily serve?
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What percentage of surface coverage does a single coat of varnish effectively provide?
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What is the primary purpose of varnishes in dental applications?
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How long does most solvent loss occur after applying varnish?
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What is the primary purpose of using liners and bases in dental procedures?
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What aspect of dentin is primarily responsible for sensing changes in fluid pressure?
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What occurs when chemical irritants leak into the pulp complex?
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How does sclerotic dentin respond to mild irritation?
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What is one reason polycarboxylate cement is considered more biocompatible than zinc phosphate cement?
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What is the defining feature of tertiary dentin?
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What is the role of the smear layer in dental procedures?
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Which statement is true regarding the bond strength increase through smear layer removal?
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Which of the following best describes the characteristics of normal coronal dentin?
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In a moderately deep tooth excavation, which material is recommended to apply as a liner at a less than ideal dentin site?
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What is the consequence of using zinc oxide eugenol when restoring with composite?
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What is a major consequence of using rotary instruments in tooth preparation?
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What is an example of a requirement for pulpal chemical protection in shallow tooth excavations?
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What is one characteristic of resin-modified glass ionomer (RMGI) in restorative procedures?
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Which factor is NOT linked to clinical judgments about the need for specific liners and bases?
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Why is it essential to consider the remaining thickness of the final restoration?
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What is the primary purpose of eugenol in dental liners?
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What effect does calcium hydroxide have when used as a liner in dental procedures?
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What is the pH characteristic of calcium hydroxide and its implications?
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What is one of the mechanical functions of cavity bases beneath restorations?
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Which of the following is a characteristic requirement for ideal dental cements?
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What is the main ingredient in the powder component of zinc phosphate cement?
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Which material is recommended to overlay on top of a calcium hydroxide liner?
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What is the main role of using dental cements at higher-than-normal powder-to-liquid ratios?
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Study Notes
Objectives of Pulp Protection
- Dentinal tubules contain odontoblastic processes and dentinal fluid
- Odontoblasts are located at the periphery of the dental pulp
- Insults to dentin can cause fluid flow in or out of the dentinal tubules, leading to sensitivity
- The smear layer provides some degree of dentinal tubule sealing, but it is porous
- Pulp protection materials are used to seal the outer ends of the dentinal tubules
Normal Dentin-Pulp Organ Defense Mechanisms
- Sclerotic dentin: Forms in response to mild irritation, such as aging or slow-advancing caries. It walls off a lesion by blocking dentinal tubules.
- Tertiary dentin: Forms in response to acute insults, such as caries or operative procedures. It is less mineralized than primary dentin and contains irregular tubules.
Terminology and Classification of Pulp Protecting Materials: Liners
- Liners are thin layers of material placed beneath restorations for pulpal protection.
- They prevent the passage of chemicals and irritants.
- Thin film liners: Are 1-50 μm thick, and include varnishes and solution liners.
- Thick liners: Are 0.2-1 mm thick, and include suspension liners and cement liners used for pulpal medication or thermal protection.
- Varnishes: Are thin films created by dissolving copal resin in a volatile solvent. They protect against chemical irritation and provide thermal insulation.
- Suspension liners: Are thicker than varnishes and provide better thermal protection.
- Calcium hydroxide liners: Stimulate the formation of reparative dentin and encourage dentin bridging. However, they may degrade over long periods.
- Zinc oxide-eugenol (ZOE) liners: Are used for pulpal medication, as eugenol has obtundent actions on the pulp.
Terminology and Classification of Pulp Protecting Materials: Bases
- Bases are thicker layers of material used to provide mechanical support and thermal protection for restorations.
- Zinc phosphate cement: Has good compressive strength and is commonly used as a base.
- Zinc oxide-eugenol cement: Provides good thermal insulation and sedative effects.
- Zinc polycarboxylate cement: Has better biocompatibility than zinc phosphate cement. It forms a chemical bond with tooth structure and has a low film thickness.
- Glass-ionomer cements (GIC): Are frequently used as bases due to their bonding ability, fluoride release, and strength.
Clinical Considerations for Pulp Protection
- Shallow tooth excavation: A varnish, dentin sealer, or bonding system may be sufficient for pulp protection.
- Moderately deep tooth excavation: A liner, such as ZOE or calcium hydroxide, may be used to provide pulpal medication and thermal insulation.
- Deep cavities: A thicker base, such as a ZOE or RMGI, may be necessary to provide thermal protection and support for the restoration.
- Considerations should be made for the remaining dentin thickness and the type of restorative material being used.
Advantages and Disadvantages of RMGI cements
-
Advantages:
- Bonds effectively to tooth structure.
- Releases fluoride.
- Sufficient strength for use under various restorations.
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Disadvantages:
- High cost.
- Potential for staining.
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Description
This quiz covers the objectives of pulp protection, normal defense mechanisms of the dentin-pulp organ, and the classification of pulp-protecting materials, specifically liners. Understand the biological processes and materials involved in dental pulp health and sensitivity management.
