Pulpal considerations for operative dentistry

Abstract

1. 1. Permanent restorative procedures should not be attempted unless the pulp is clinically normal. 2. 2. Maximal dentin thickness or “effective depth” between the wall of the restoration and the pulp offers the best protection for the pulp. This includes the injury that can result from caries, grinding procedures, or filling materials. 3. 3. All burs produce a rise in temperature while cutting enamel and dentin. Temperature elevations can be reduced by the use of burs with small diameters with a light amount of pressure. 4. 4. Handpiece water coolants are necessary in order to keep the pulpal responses minimal when using operating speeds above 50,000 r.p.m. Tooth thickness varies and this is of benefit in minimizing the inflammatory response of the pulp. Cavity extension is the critical phase of cavity preparation in producing a traumatic response. 5. 5. Adequate vision is necessary to produce proper cavity preparations. There is no substitute for the use of the rubber dam to obtain an acceptable operating field. 6. 6. The conservation of the pulp and tooth structure must be realized in all diagnoses and treatments for complete restorative service. No material or technique should serve as a substitute for sound operative procedures.