Fixed Prosth: September 2007 Archives
We are well aware of the hydro-dynamic theory of tooth sensitivity. The dentin tubules that lie between the enamel [or cementum] and the pulp chamber are filled with fluid. When they are opened [due to a cavity or a dentist] a greater amount of movement of the fluid is created. This movement is created even after the tooth has been filled, because of several reasons, but most often because it wasn't sealed. When this change in pressure is too great, it causes an action potential in the nerve to fire, illiciting a pain response.
Thanks to the advent of etching and bonding, we are able to seal these tubules very predictably. If most dentists are aware of this, why don't we take advantage of it more often? Of course, we have to use bonding agents for successfull composite restorations. What about other operative restorations like inlays, onlays, and amalgam? Should we be taking advantage of it during our crown preparations as well?
Are there contra-indications to using bonding agents with diferent cements? Or, could we bond our crowns in place of using luting agents?
A search of the literature is in order, I believe.
