Dycal

[ItsGavinC]

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Who here has had experience using Dycal? I've used it to cover a minor pulp exposure, but have heard that some use it for quite a bit more. Any experiences? Any alternatives to those other uses?

Just curious. I don't want to get in the rut (although it WILL happen) of only being familiar with the supplies that my school pushes on us.

 

[ItsGavinC]

Who here has had experience using Dycal? I've used it to cover a minor pulp exposure, but have heard that some use it for quite a bit more.

For example, I've heard of clinicians using Dycal as a liner for all of their preps prior to placing composite. Anybody do this?

 

[BDS-DMD]

Basically,its important to understand the difference between Dycal and Calcium Hydroxide. Dycal is MAINLY used for Direct and Indirect Pulp capping. Thats if there is a TRAUMATIC(NOT carious) pin point exposure,then you can apply dycal over it and temporize it. Dycal stimulates secondary Dentin formation due to its high pH and proteinilysing effect. If the patient is fine for 4-6 weeks,then go ahead and restore it. Otherwise Endo. The same principle for indir PC is true. The only difference is the lack of an actual exposure. But there is less than 0.5 mm of Dentin and there is a chance of pulp getting involed.

Some clinicians use Dycal as a liner under composite in deep cavities as the acid is likely to irritate the pulp. Both the acid used for etching and the one in GIC(which is also used as a liner).

Cal Hydro is a totally different story all together.

I will write about that some other day.

 

[LestatZinnie]

we learned in class to use Dycal or calcium hydroxide only if there's chance of pulp exposure. it's not a very strong material so using it as a liner may compromise the restoration, although i have no idea how thick you have to apply it normally. with the acidity protection..we were told that you can put some dycal or not when you do total etch direct pulp cap. i dont think there is a consensus that etching close to the pulp will cause damage?

 

[ItsGavinC]

Well, as I said, I've only used it for minor pulp exposure (just a dab on the exposure) prior to provisionalizing.

I've heard that placing Dycal prior to placing composite material will decrease the sensitivity of posterior composite restorations (it's theorized that posterior composites sometimes have increased sensitivity due to shrinkage and pulling on the dentinal tubulues as they shrink).

I just want to make sure that I'm not way off base by using it only for minor pulp exposure and nothing else at this point.

 

[DcS]

Most faculty in our school send us straight to endo with a pulp exposure, regardless if it was carious or mechanical.

I think our endo department has the philosophy of preventative endo.

In any case, this may be off but I believe a faculty member in endo who does a lot of work in the research aspect told me that direct pulp caps have about a 50% failure rate withing 5 years.

 

[ktcook83]

Gavin,

There was a discussion about dycal in the latest Dentaltown mag. It was from a thread there, so try searching Dentaltown forums for dycal as well.

 

[LestatZinnie]

Most faculty in our school send us straight to endo with a pulp exposure, regardless if it was carious or mechanical.

I think our endo department has the philosophy of preventative endo.

In any case, this may be off but I believe a faculty member in endo who does a lot of work in the research aspect told me that direct pulp caps have about a 50% failure rate withing 5 years.

the thing about dentistry is that there are often many ways of doing things. our endo prof is pretty gunho and is really into preventive endo as well, while many other profs are more conservative and are willing to just wait and see if the pulp would be able to heal if pulp exposure is minimal.

as for minimizing dentinal tubule leakage, if the etch and bond is done correctly with a flowable layer as stress breaker and incremental placement, there shouldnt really be a need to use dycal, imo.

 

[ItsGavinC]

Thanks for all the responses!

DcS, do you agree with sending all exposures to endo? Like I said, although I'm new to clinical work, I can understand that I'm really getting one take out of thousands as to how dentistry should be done. I'm interested in hearing other methods and the theories behind them.

 

[DrTacoElf]

As posted above check out the new dental town mag. Although i'm guessing thats how you brought up the topic...