Ultradent Katalog

Deep interproximal lesions often lead to inflammation and an increased tendency to bleed. Restorative treatment, however, can only begin after effective hemostasis has been achieved. The natural tooth contour is subsequently reconstructed using a suitable matrix system.

TISSUE MANAGEMENT Tissue Management in challenging cases Deep interproximal lesions often lead to inflammation and an increased tendency to bleed. Restorative treatment, however, can only begin after effective hemostasis has been achieved. The natural tooth contour is subsequently reconstructed using a suitable matrix system. 1. Old, fractured amalgam filling. The patient has been chewing on the fragments for months leaving the gingiva inflamed. 2. Old amalgam removed. The caries is kept as a barrier for the time being, in case the pulp is exposed. 3. The gingival margin of the restoration is exposed before placing a rubber dam. Bring forward step 4, if necessary, to improve visibility. 4. Profound hemostasis is achieved by applying ViscoStat or Astringedent X with the brush end of the Dento-Infusor Tip. 5. Place a dental dam, then remove residual caries. Treat exposed pulp if necessary. Etch and bond with Peak LC Bond. 6. DO NOT wedge the matrix band until the first layer of composite has been placed. 7. CORRECT: First, place the matrix band to create a gingival seal, then place the first layer of composite. (Optional: Etch and bond after placing the matrix band, then place the first layer of composite.) 8. Wedge after the first layer. Loosen matrix band and contour for good interproximal contact. Place an initial adaptive layer with PermaFlo, and fill cavity with Amelogen plus. Deciduous vital pulpotomies If the coronal pulp of a deciduous tooth is inflamed, pulpotomy may help keep the tooth in function until it is replaced by its permanent successor. Ferric sulfate preparations increasingly replace formocresol for hemostasis of the residual pulp, as they are kinder to hard and soft tissues while showing good hemostatic effects. ! 1. Control bleeding. Use Dento-Infusor Tip with ViscoStat or Astringedent. 2. Sustained Antimicrobial. Apply a thin layer of ZOE mixed to a putty. 3. Eugenol Barrier. Apply a thin layer of Ultra-Blend plus, since eugenol inhibits most resin polymerization. Remove all hemostatic and extraneous coagulum prior to placement of the thin layer of ZOE. Excavate extraneous coagulum, if needed, prior to delivering a firm air/water wash to avoid internal resorption. Apply ZOE and Ultra-Blend plus in minimal thickness to keep maximum dentin avai-lable for bonding. 4. Etch. Apply Ultra-Etch 35% phosphoric acid, or Peak SE. 5. Bond. Apply PQ1 dentin bonding agent, or Peak LC Bond. 6. Restore: Use PermaFlo and/or Amelogen Plus as desired. 46