WEBVTT

00:00.000 --> 00:30.000 position:50% align:top line:0%
*This machine-generated transcript may have errors. If remediation or a manually-generated transcript is needed, please contact NLM Support at https://support.nlm.nih.gov.*

00:26.170 --> 00:28.620
This program demonstrates how to properly

00:28.620 --> 00:31.560
place three pulp protection materials,

00:31.890 --> 00:34.660
calcium hydroxide cavity varnish

00:34.860 --> 00:36.480
and zinc phosphate cement.

00:37.210 --> 00:39.910
The Museo ACLU cell preparation is on the

00:39.910 --> 00:40.750
lower right.

00:40.760 --> 00:43.730
First molar we are using the rubber

00:43.730 --> 00:45.810
dam to facilitate visibility.

00:48.780 --> 00:51.430
After viewing this program and practicing the

00:51.430 --> 00:53.410
procedures with your own materials.

00:53.660 --> 00:56.480
You should be able to properly demonstrate the

00:56.480 --> 00:58.140
pulp protection techniques.

00:58.150 --> 01:00.980
According to the following criteria for

01:00.980 --> 01:01.900
evaluation,

01:06.170 --> 01:08.550
one proper mixing of protection

01:08.550 --> 01:11.160
materials according to the manufacturer's

01:11.160 --> 01:11.900
directions

01:14.560 --> 01:17.090
to proper location of protection

01:17.090 --> 01:19.680
materials within the cavity preparation.

01:20.380 --> 01:22.730
This includes proper sequencing of

01:22.730 --> 01:25.290
materials and avoiding the cave oh

01:25.290 --> 01:27.750
surface margins to prevent restorative

01:27.750 --> 01:28.580
breakdowns

01:33.140 --> 01:35.660
and three restoration of the cavity

01:35.660 --> 01:38.000
preparation to ideal form.

01:38.700 --> 01:41.510
This includes proper contour and provision of

01:41.510 --> 01:44.270
sufficient depth for the restorative material.

01:48.730 --> 01:51.200
The following materials are suggested for this

01:51.200 --> 01:51.870
procedure.

01:52.610 --> 01:55.120
Mirror explorer calcium

01:55.120 --> 01:57.100
hydroxide such as hydraulics,

01:57.410 --> 02:00.190
mixing pad and applicator cavity

02:00.190 --> 02:00.750
varnish,

02:00.760 --> 02:03.450
such as copa light cotton balls and

02:03.450 --> 02:05.610
gauze cotton pliers,

02:06.080 --> 02:08.460
cement and liquid base such as flex

02:08.460 --> 02:10.850
zinc phosphate glass

02:10.850 --> 02:11.630
slab,

02:12.040 --> 02:13.540
mixing metal spatula

02:14.730 --> 02:17.380
plastic instrument and small and

02:17.380 --> 02:18.380
large pluggers.

02:26.630 --> 02:28.910
Use of the three protective materials,

02:29.110 --> 02:32.000
calcium hydroxide cavity varnish and

02:32.000 --> 02:34.830
zinc frost fate depends upon the depth and

02:34.830 --> 02:36.500
extent of the preparation.

02:37.520 --> 02:40.450
Look at this preparation carefully note that

02:40.450 --> 02:41.990
the floor is not level.

02:42.820 --> 02:45.480
The preparation extends deeper towards the

02:45.480 --> 02:48.400
pulp on the Aclu's and proximal

02:48.400 --> 02:49.490
box areas.

02:51.390 --> 02:54.010
Calcium hydroxide such as hydraulics

02:54.400 --> 02:57.090
is used to protect the pulp from acids.

02:57.970 --> 02:58.870
Primarily,

02:58.900 --> 03:01.560
it is used to stimulate secondary Denton

03:01.560 --> 03:04.340
formation which ultimately prevents

03:04.350 --> 03:05.290
sensitivity.

03:16.970 --> 03:19.190
Contra indications calcium

03:19.190 --> 03:22.170
hydroxide should not be used for thermal

03:22.170 --> 03:25.090
insulation and base preparation build

03:25.090 --> 03:25.390
up

03:30.440 --> 03:32.500
for this preparation combined.

03:32.510 --> 03:35.220
Equally small portions of the two tubes of

03:35.220 --> 03:37.570
hydraulics mixing quickly with the

03:37.570 --> 03:39.930
applicator to a creamy uniform

03:39.930 --> 03:42.720
consistency work rapidly as the

03:42.720 --> 03:45.680
protective agent sets quickly then wipe

03:45.680 --> 03:46.960
the applicator clean

03:50.700 --> 03:53.630
using the tip dab a small amount of

03:53.630 --> 03:56.520
the hydrates mixture on the deepest portion of the

03:56.520 --> 03:59.420
cavity being careful not to get

03:59.430 --> 04:01.610
any on the cable surface margins,

04:02.860 --> 04:05.620
apply the hydrates until the deepest area

04:05.690 --> 04:06.330
is covered.

04:07.900 --> 04:10.690
The remainder of the area will be filled with base

04:10.810 --> 04:11.800
to ideal form.

04:12.700 --> 04:15.460
If any hydrates should contact the cable surface

04:15.460 --> 04:16.130
margins,

04:16.400 --> 04:17.990
remove it with an explorer.

04:22.830 --> 04:24.680
When poeple exposures occur.

04:24.780 --> 04:27.680
Calcium hydroxide is used to stimulate

04:27.680 --> 04:29.860
production of reparative Denton.

04:30.170 --> 04:30.870
However,

04:30.880 --> 04:33.460
it is generally used with a cement base

04:33.640 --> 04:36.280
because calcium hydroxide is not a

04:36.280 --> 04:37.340
thermal insulator.

04:38.400 --> 04:41.000
Calcium hydroxide may occasionally be

04:41.000 --> 04:43.950
used alone for leveling slight depressions

04:43.960 --> 04:46.590
or undercut areas in an otherwise

04:46.600 --> 04:47.860
ideal preparation.

04:48.050 --> 04:50.480
When it is not intended for thermal

04:50.480 --> 04:52.690
insulation or possible exposures.

04:58.820 --> 05:01.190
After the calcium hydroxide is set,

05:01.580 --> 05:04.200
apply the cavity liner or varnish.

05:04.350 --> 05:05.730
We are using co polite.

05:06.960 --> 05:09.880
This application of cavity varnish seals

05:09.880 --> 05:12.870
off the dental tubules which helps prevent

05:12.880 --> 05:14.180
thermal sensitivity.

05:18.130 --> 05:20.780
Cavity varnish is contraindicated for

05:20.780 --> 05:23.650
placement directly on possible exposures

05:27.650 --> 05:28.430
to apply,

05:28.710 --> 05:31.450
dip a small wad of cotton into the copa light

05:31.450 --> 05:33.770
jar and wipe it on the preparation.

05:34.190 --> 05:36.270
Avoiding the cable surface margins,

05:37.450 --> 05:39.970
then blow dry and remove any marginal

05:39.980 --> 05:42.690
excess with an explorer or damp

05:42.690 --> 05:43.750
cotton swab.

05:44.470 --> 05:47.050
Cavity liner may accompany based cement

05:47.060 --> 05:49.430
or be used alone for any

05:49.430 --> 05:50.290
preparation.

05:50.370 --> 05:51.840
That is an ideal form.

05:54.590 --> 05:57.180
The zinc phosphate cement base may be

05:57.180 --> 05:59.890
placed next to provide further protection.

06:02.430 --> 06:04.830
Zinc phosphate is used to

06:04.840 --> 06:07.690
one provide thermal insulation to

06:07.690 --> 06:10.510
prevent sensitivity to the tooth and

06:10.510 --> 06:13.300
to to restore the preparation to ideal

06:13.300 --> 06:13.790
form.

06:14.410 --> 06:17.390
It may be used alone or in combination with

06:17.390 --> 06:20.190
cavity varnish depending upon the depth of the

06:20.190 --> 06:21.020
preparation.

06:21.980 --> 06:24.390
It may also be used without calcium

06:24.390 --> 06:27.270
hydroxide if the preparation is

06:27.270 --> 06:29.500
void of deep purple extensions.

06:35.630 --> 06:38.560
Counter indications include preparations where

06:38.560 --> 06:41.190
there is insufficient death to place the permanent

06:41.200 --> 06:43.680
restored of material and possible

06:43.680 --> 06:44.400
exposures.

06:44.880 --> 06:47.830
Placing the acidic zinc phosphate close to the pulp

06:47.840 --> 06:50.810
wood cause patient discomfort and possibly the

06:50.810 --> 06:52.200
death of the Popol tissues.

06:55.420 --> 06:58.210
Visually conceptualize the amount of powder

06:58.220 --> 07:01.140
and liquid to be needed depending upon the

07:01.140 --> 07:02.760
extent of the preparation.

07:04.040 --> 07:07.020
Use a cool dry glass lab

07:07.150 --> 07:09.890
to prevent the mixture from setting up too quickly.

07:11.780 --> 07:13.960
When combining the two ingredients,

07:13.970 --> 07:16.660
always add small increments of

07:16.660 --> 07:18.140
powder to the liquid.

07:18.730 --> 07:21.640
Mixing each edition slowly and

07:21.640 --> 07:23.240
over a wide area for

07:23.240 --> 07:25.330
30-45 seconds.

07:26.780 --> 07:29.420
This is important in order to reduce the

07:29.420 --> 07:29.820
heat,

07:30.070 --> 07:32.890
which would cause the mixture to prematurely set.

07:45.940 --> 07:48.050
When the mixture reaches a doughy

07:48.050 --> 07:48.980
consistency,

07:49.350 --> 07:52.050
pick up small amounts with your fingers and

07:52.050 --> 07:54.620
roll the material into small balls.

07:56.350 --> 07:59.220
Larger balls would be used for larger preparations.

08:00.390 --> 08:03.130
The base material should not stick to your fingers,

08:39.750 --> 08:42.070
place the ball in the prescribed area,

08:42.780 --> 08:45.470
then dip your plugger into the remaining powder

08:45.680 --> 08:48.240
to keep the base from sticking to your instrument

08:48.860 --> 08:51.020
and press the material into place.

08:52.310 --> 08:55.280
If there is excess material left on your instrument,

08:55.320 --> 08:58.210
wipe it off before dipping it into the powder.

08:59.220 --> 09:02.100
Use a small or large plugger depending

09:02.100 --> 09:04.380
upon access and interchange

09:04.380 --> 09:05.690
instruments as needed.

09:22.030 --> 09:24.100
If more material is necessary,

09:24.470 --> 09:27.450
repeat the process until the desired height

09:27.460 --> 09:30.430
is achieved contour,

09:30.430 --> 09:32.850
the base to ideal preparation form

09:33.310 --> 09:35.780
as if there had been sufficient tooth structure.

09:38.850 --> 09:41.460
Remember to allow sufficient depth for the

09:41.460 --> 09:44.300
restorative material to be able to adhere

09:44.390 --> 09:45.700
and retain its strength.

09:51.980 --> 09:54.860
Although we are demonstrating this procedure on a

09:54.860 --> 09:55.910
type of tooth,

09:56.480 --> 09:59.130
you would not extend the height of the base into the

09:59.130 --> 09:59.670
enamel.

10:00.490 --> 10:03.220
The dental enamel margin can easily be seen

10:03.230 --> 10:05.330
on this real extracted tooth

10:06.180 --> 10:09.120
note that the Denton is more yellow in color than the

10:09.120 --> 10:10.010
lighter enamel.

10:15.410 --> 10:17.640
Avoid filling in the retention points.

10:17.980 --> 10:19.000
If this happens,

10:19.010 --> 10:20.860
they must be replaced by the dentist.

10:23.870 --> 10:26.550
Do not place the base against the cable surface

10:26.550 --> 10:29.180
margins of the preparation or they may

10:29.180 --> 10:31.180
cause the restoration to leak,

10:39.200 --> 10:42.040
then smooth the surfaces of the base with your plugger

10:42.050 --> 10:44.550
or chisel to permit easy placement of the

10:44.550 --> 10:45.350
restoration

11:17.210 --> 11:19.820
fill in any undercuts such as the buckle

11:19.820 --> 11:20.250
flare.

11:20.250 --> 11:21.030
Seen here,

11:21.630 --> 11:24.560
the retention points would be replaced in cement by

11:24.560 --> 11:25.160
the dentist

12:15.890 --> 12:16.190
note.

12:16.190 --> 12:18.980
The criteria for properly placed cement

12:18.990 --> 12:20.040
based protection.

12:21.000 --> 12:22.460
The base should be contoured.

12:22.650 --> 12:24.080
So that one,

12:24.410 --> 12:27.410
the poeple floor is restored to normal cavity

12:27.410 --> 12:28.590
preparation depth

12:33.500 --> 12:36.380
to the axle wall has adequate

12:36.390 --> 12:39.050
depth for the restoration from the cave oh,

12:39.050 --> 12:40.110
surface margin.

12:43.850 --> 12:44.400
three,

12:44.780 --> 12:47.640
the axle wall is parallel to the previously

12:47.640 --> 12:49.700
existing proximal service

12:52.540 --> 12:55.490
for the base height would not extend into the

12:55.490 --> 12:57.120
enamel of a real tooth.

13:02.000 --> 13:02.710
five,

13:03.370 --> 13:05.920
the retention points remain unfilled

13:06.110 --> 13:07.400
or are replaced.

13:13.370 --> 13:14.010
six,

13:14.560 --> 13:17.410
the margins are free from excess base material

13:21.580 --> 13:22.390
And seven,

13:22.830 --> 13:25.630
the base is smooth and ready to receive the

13:25.630 --> 13:26.960
restorative material.

13:28.720 --> 13:31.680
Note that the undercut in the enamel beneath the cusp

13:31.960 --> 13:34.920
has been filled and smoothed to ideal preparation

13:34.920 --> 13:35.360
form.

13:37.100 --> 13:39.830
We have just demonstrated placing three pulp

13:39.830 --> 13:41.090
protection materials,

13:41.420 --> 13:44.330
calcium hydroxide cavity varnish

13:44.480 --> 13:46.170
and zinc phosphate cement.

13:47.110 --> 13:49.420
Please practice these procedures with your own

13:49.420 --> 13:52.030
materials and ask your instructor for any

13:52.030 --> 13:53.300
further assistance.