METHOD OF APPLICATION OF THERAPEUTIC PADS

Lecture on propaedeutics of therapeutic dentistry

Subject: FILLING MATERIALS: CLASSIFICATION, CLASSIFICATION REQUIREMENTS FOR THEM. THEIR INFLUENCE ON THE TISSUES OF THE TOOTH AND THE SURROUNDING TISSUES. CHOICE OF FILLING MATERIAL. CEMENTS, HEALING AND INSULATING GASKETS

All filling materials are divided into 4 large groups: temporary and permanent, materials for insulating gaskets and root canal filling. There are also materials for sealing fissures.

TEMPORARY filling materials are intended for the isolation of medicinal substances, for clinical reasons, in case of delayed treatment of caries or its complications, for a period of 1-3 days to 6 months.

Requirements for temporary filling materials:

ü Plasticity

ü The material should be easy to enter and easy to remove from the carious cavity

ü Do not inactivate drugs

ü Must be indifferent to the dental pulp and oral mucosa

ü Do not dissolve in oral fluid

ü Ensure hermetic closure of the defect for the required period

Method of mixing: temporary materials are mixed on the rough side of the glass plate, with a spatula of any material. They are injected into the carious cavity in one portion, do not condense (i.e., do not press tightly), only smooth with a cotton swab.

Temporary filling materials include artificial dentin (zinc sulfate dentin) . Features: kneaded with distilled water, it is very important to thoroughly dry the carious cavity, otherwise the material will not cure. Only this material can isolate arsenic paste, resorcinol-formalin mixture, because. the hardening time of the material is 1-3 minutes, it will not allow fluid and poisonous materials to spread to the oral mucosa.

Dentin-paste – consists of artificial dentin and glycerin-vaseline base. It has good adhesion, hardens in a humid environment, at oral temperature, within 8-10 hours. Service life 7-10 days.

Vinoxol – has good adhesion, does not irritate the tooth pulp, has sufficient mechanical strength, service life up to 6 months.

Zinc-eugenol cement. At the temperature of the oral cavity, it hardens within 8-12 hours. It is also used as a medical pad because it has good regenerative, antiseptic and analgesic properties.

Polycarboxylate cement – is intended not only for temporary filling, but also for filling k.k., fixing orthopedic structures and restorations of milk teeth. It is not used for filling permanent teeth due to low mechanical strength.

FILLING MATERIALS USED FOR GASKETS. They are divided into 2 large groups: therapeutic and isolating.

Medical pad (syn. Subbasic) – superimposed on the bottom of the carious cavity for medicinal action on the pulp, the remaining microflora, decalcified dentin for its mineralization. Used in the treatment of deep caries, traumatic, acute focal and chronic pulpitis.

CLASSIFICATION OF THERAPEUTIC PADS

1. Materials containing calcium hydroxide:

– chemical curing

-light curing (light curing)

2. Zinc-eugenol cements:

– actually zinc-oxide-eugenol cements:

-hardened zinc oxide-eugenol cements with filler.

– zinc oxide-eugenol cements with orthobenzoic acid (EVA)

3. Combined medicinal pastes:

– ready-made combined medicinal pastes

– combined medicinal pastes prepared in a pharmacy

REQUIREMENTS FOR THERAPEUTIC PADS

Medical pads should:

ü Do not irritate the dental pulp

ü Anti-inflammatory and reparative effect on the pulp

ü Possess bactericidal and bacteriostatic action

ü Have good adhesion

ü Be flexible

ü Withstand pressure after hardening

METHOD OF APPLICATION OF THERAPEUTIC PADS

After the tooth is isolated from saliva, an antiseptic treatment of the carious cavity is carried out with weak antiseptic solutions, the carious cavity is dried with a weak stream of air or with a sterile cotton swab. The use of aggressive antiseptic substances such as alcohol is excluded. Then the choice of medical lining is made, the possibility of direct and indirect pulp capping is taken into account. Because The medical lining does not have adhesion to the dentin, it should not cover the entire bottom of the carious cavity. The therapeutic pad is applied to the protruding horn of the pulp or in the deepest part of the bottom of the carious cavity. An insulating layer is applied over the medical pad, the thickness and level, which depends on the restorative material of the permanent filling. In case of delayed treatment, a temporary filling is placed over the medical pad. After 2-4 days, in the absence of complaints, the temporary filling is removed and the previously described method of filling the carious cavity is repeated.

INSULATION GASKETS – this is a gasket located between the filling and the dentin of the cavity. There are basic and thin-layer (liner) gaskets .

The base lining is a thick layer of lining material made of cements that restores the dentin of the tooth and is able to protect the pulp from chemical and thermal irritants without worsening the retention properties of the cavity, as well as mechanically strengthening the thinned walls of the tooth. In addition, the base pad can withstand chewing pressure and the stress associated with the condensation of materials (amalgam). The thickness of the base gasket is 0.75-1 mm.

Liner pad. Its thickness is 0.5-0.7 mm; it is also prepared from cements. Such a pad protects the pulp from the chemical attack of the permanent material, but does not protect the pulp from thermal irritants. Depending on the material of the permanent filling, the liner can be applied to the bottom and walls of the cavity, repeating its shape. Lacquer gaskets are also liner.

Requirements for insulating gaskets – must have:

ü Good biological compatibility with pulp, hard tissues of the tooth

ü Have a coefficient of thermal expansion close to the hard tissues of the tooth

ü Have low thermal conductivity

ü Have good adhesion

ü Do not change the color of the tooth

ü Have low polymerization shrinkage

ü Be radiopaque

ü Do not change the geometry of a well-formed cavity

ü Improve marginal fit of permanent fillings

ü Be impervious to acids and monomers released during the hardening of the permanent filling

ü Reduce polymerization shrinkage of restorative materials

ü Have an anti-caries effect

ü Carry the static load associated with the redistribution of masticatory pressure

ü Protect the treatment pad from adverse interaction between it and the restorative filling

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