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Medical Forum / General / Dentistry / May 2007pulp cap
I seek a dentist or endodontist to perform a pulp cap procedure Gordon and ?  Signature/ Amatus / >I seek a dentist or endodontist to perform a pulp cap procedure > Gordon Most of the best pulp caps that I have seen used gutta-percha to the apical foramen. ;-) D > and ? Excellent ! Besides ~90% of direct pulp caps will fail in 5 years. >Most of the best pulp caps that I have seen used gutta-percha >to the apical foramen. [quoted text clipped - 3 lines] > >> and ? > Excellent ! > [quoted text clipped - 9 lines] > > - Show quoted text - still 5 years could buy someone without the money to do an endo 5 years to save up. It also gives them time to get really mad and say, "That tooth you filled is KILLING ME!" <G> Be careful. :-) Steve > still 5 years could buy someone without the money to do an endo 5 > years to save up. Yep, and it's always *your* fault ! >It also gives them time to get really mad and say, "That tooth >you filled is KILLING ME!" <G> [quoted text clipped - 6 lines] >> still 5 years could buy someone without the money to do an endo 5 >> years to save up. >> Excellent ! >> [quoted text clipped - 12 lines] >still 5 years could buy someone without the money to do an endo 5 >years to save up. Direct pulp capping is a waste of time and money for the patient. It will ultimately fail and at the most inconvenient time. Most don't make it 5 yrs. When was the last time you saw that happen? Temporize it without planning to do the RCT within two months, and the patient ignores it until their face swells up a few years later and the tooth is extracted. Signature/ Amatus / <> > still 5 years could buy someone without the money to do an endo 5 > years to save up. > When was the last time you saw that happen? Temporize it without planning > to do the RCT within two months, and the patient ignores it until their face [quoted text clipped - 12 lines] > > - Show quoted text - well when i do pulp caps, it's the patient's decision and good communication is always key. if you they are well informed and still decide to take the "chance" that something bad will happen they don't blame me for anything. Some last, some don't. I tell the patient it will most likely need an endo, maybe even as early as tomorrow, but you can always go to the endo in the future. once you do it, there is no going back. There have been articles going both ways. if you are the kind of doctor that likes some thing very predictable go the endo route. some people like to have choices, and as long as they know both the benefits and disadvantages/risks it is up to them. if you they are well informed and still > decide to take the "chance" that something bad will happen they don't > blame me for anything. The ones who come back to see you, don't blame you. The ones who come to my office after you did the work, do. <G> Communication only works when the receiver is on and tuned to the right channel! I'm not saying that I never do them, especially since the SE bonds have come on the market. However, it is usually for a kid whose parents aren't going to save a tooth for them, or a young adult who is struggling to get on their own. Even then, I know most of them are not going to follow through when the time becomes necessary. Best wishes, D Agree with both of these points. Don't get me wrong, have done many a pulp cap, especially in my earlier days. Now it is in very specific instances and not a routine procedure. IIRC MTA is now the material of choice for treatment of mechanical exposure. Understand that this material is somewhat difficult to work with and I haven't actually used it, so YMMV... > if you they are well informed and still >> decide to take the "chance" that something bad will happen they don't [quoted text clipped - 16 lines] >Best wishes, >D >Check the recent research. CaOH is no longer thought to stimulate dentin >formation. It is thought to be bactericidal due to its pH. Plus, it [quoted text clipped - 6 lines] >saliva while I design and mill (about 10-15 minutes). Just before bonding, >I flick off the CaOH and bond right to the exposure. MTA............ The cute little carrier instruments they make for it do not work very well at all. I always end up scooping it up with an excavator or a plastic instrument and packing it on. I have used it for furcal perforations and repairing poorly done post preparations. For pulp caps, (mechanical exposure), I always just etch and bond right over it with nothing in between. Someday, I expect to have one of these act up,,,,, I'll let you know when that happens. Signature/ Amatus / > > Agree with both of these points. [quoted text clipped - 46 lines] >>bonding, >>I flick off the CaOH and bond right to the exposure. Mechanical exposures which occur while trying to shape a preparation, are routinely capped by me with no problems. Carious exposures,,,,,,, never. There are times when the patient says they cannot afford the RCT for 2-4 months, and I will extirpate and temporize. If they do not return in 6 weeks, they generally never do. Signature/ Amatus / >> When was the last time you saw that happen? Temporize it without >> planning [quoted text clipped - 25 lines] > route. some people like to have choices, and as long as they know > both the benefits and disadvantages/risks it is up to them. >> When was the last time you saw that happen? Temporize it without planning >> to do the RCT within two months, and the patient ignores it until their face [quoted text clipped - 23 lines] >route. some people like to have choices, and as long as they know >both the benefits and disadvantages/risks it is up to them. As I have said before carious exposures should be treated with root canal therapy. It is generally accepted by the endodontic community that most pulps can sustain only 2 - 3 operative traumas before suffering pulpal problems. Carious exposure should be treated with root canal therapy period. >When was the last time you saw that happen? Temporize it without planning >to do the RCT within two months, and the patient ignores it until their face >swells up a few years later and the tooth is extracted. > >> still 5 years could buy someone without the money to do an endo 5 >> years to save up. >I seek a dentist or endodontist to perform a pulp cap procedure >Gordon Try www.aae.org American Association of Endodontists Think they have listings. |
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