Recently in Operative Category
But when you're patient is anesthetized, they have no idea what you've done in their mouth. When [as dental students working without assistants] you are working by yourself it is important to isolate the area where you are working. I have tried everything, including the sphedopter [sp?] that was in our kits. What I have learned is that the cotton roll is my friend, and if I'm doing any sort of opperative the rubber dam is the best thing going.
There is nothing worse than hurting the very person we are trying to help. Except, having to let them know that they will be sore when the anesthetic wears off.
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.
