Indirect Pulp cap question..

[Demeter]

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What are you guys using? Dycal, Vitrebond, Ultrablend ?
When are you supposed to use Dycal & when is it not indicated?

 

[Demeter]

Need reply.

 

[dentalman]

We use dycal at UWashington. From what I recall, it is indicated when you want to form secondary dentin. So, that would be when you get close to the pulp, but there is still demineralized dentin. Place dycal, a temporary, and wait to see if the tooth explodes or hopefully more dentin forms. But if you do get a small mechanical exposure (slipping of the bur, not gross caries), then placing dycal would be indicated. If there is gross caries clearly in the pulp, and O&B would be indicated. I'm not looking at my textbook, so anyone feel free to pipe in. Also remember that Eugenol (found in IRM) has a therapeutic effect, which is why it is used in temporary (sedative) restorations. It will either calm down, or get really bad. Then you'll know whether it needs pulpal therapy.

This feels like a test question!

 

[dentalman]

Sometimes we also use dycal even if it is hard dentin but still close to the pulp, in the hopes of creating a larger dentinal barrier between the pulp and the restoration.

 

[DrTacoElf]

Yeah just relized I answered my own question 😀 . But I do have one more. If you do a direct pulp cap is it common to use temporary material and reschedule the patient or do you go ahead with the final direct restoration?

 

[Doggie]

Yeah just relized I answered my own question 😀 . But I do have one more. If you do a direct pulp cap is it common to use temporary material and reschedule the patient or do you go ahead with the final direct restoration?

THe way we did it depends on the status of the tooth. If the tooth was symptomatic to begin with, I would put temp stuff in hopes to quell the tooth.....and only when the patient REALLY REALLY wanted to avoid the cost of endo tx. If the tooth was asymptomatic, I would just fill it permanently.

But then again......I'd always have the urge to bust out a #150.

 

[Demeter]

Dycal is a strange material. It stimulates secondary Dentin, but it also an irritant to the pulp.

 

[DrTacoElf]

Dycal is a strange material. It stimulates secondary Dentin, but it also an irritant to the pulp.

interesting -- i was reading over on DT about post op sensitivity and everyone basically said they hated dycal because it caused too much sensitivity.

 

[DcS]

Dycal is a strange material. It stimulates secondary Dentin, but it also an irritant to the pulp.

It causes internal resorption but I think the research is shaky.

 

[herodontist]

Dycal is a strange material. It stimulates secondary Dentin, but it also an irritant to the pulp.

Actually, dycal has a highly alkaline pH, which is why it irritates and usually causes necrosis of any pulpal tissue in contact with it or very close to it. It's this irritation which stimulates the remainder of the pulp to react and form secondary dentin or calcific barriers. So without the irritant effect, there'd be no secondary dentin formation.

 

[tx oms]

I cover the hole over the pulp with a 150 beak and squeeze.

 

[tx oms]

Need reply.

Buy a book or read an article Einstein.

 

[gonnabdds]

Actually, dycal has a highly alkaline pH, which is why it irritates and usually causes necrosis of any pulpal tissue in contact with it or very close to it. It's this irritation which stimulates the remainder of the pulp to react and form secondary dentin or calcific barriers. So without the irritant effect, there'd be no secondary dentin formation.

The main benefit of dycal is that it's bacteriocidal.