Re: Tooth Ache

>
> In fact this is true. Even back in the dark ages of my dental school, we
> were told that Ca(OH)2 wouldn't hold up as a base, but that it could serve
> as a liner. But we were advised to use zinc phosphate cement for bases.
> I have removed many an old amalgam to find an intact zinc phosphate or
> copper cement base underneath,
>

If you look closely to see why the filling failed, you can usually track it
to metal fractures over the cement base. Studies show CaOh will actually
disappear eventually under a restoration. It will leave an empty space. So
a thick layer of CaOh is much worse than the Tenacin base.

--
/

Amatus

/
"Mark & Steven Bornfeld" <bornfeldmung@xxxxxxxxxxxxxxx> wrote in message
news:aFnlf.16638$ad6.8534@xxxxxxxxxxx
> El Parador wrote:
>
>> Amatus Cremona wrote:
>>
>>> Let me argue in a friendly tone, If such things are possible in Usenet.
>>
>>
>> Why not?
>>
>>> Never place cement bases under amalgams as they compress more than the
>>> metal does and lead to fractures through the amalgam.
>>
>>
>> That's the first thing I heard about that. Is there some literature about
>> this? I know pure amalgam restorations can handle more stress, but that
>> placing a base is drastically influencing the lifespan of a filling is
>> new. I've have seen fillings placed by a peer that are there for 20
>> years. With a classical zinc phosphate base.
>
> In fact this is true. Even back in the dark ages of my dental school, we
> were told that Ca(OH)2 wouldn't hold up as a base, but that it could serve
> as a liner. But we were advised to use zinc phosphate cement for bases.
> I have removed many an old amalgam to find an intact zinc phosphate or
> copper cement base underneath,
>
> Steve
>>
>> How do you solve the problem of the sensitivity to temperature when you
>> don't place a base?
>>
>>> CaOh has been shown to NOT effect the long term health of a tooth.
>>
>>
>> That's again not my clinical experience. Especially in primary teeth CaOH
>> placement has a good effect on the long term health of the tooth. I have
>> to admit I'm not so certain about permanent teeth, but I've managed to
>> save some pulps with indirect capping.
>>
>>> Total etching does not injure pulps unless you leave it on for a few
>>> minutes. And, if you routinely have pain after placing posterior
>>> composites, your technique needs modification.
>>
>>
>> But I don't. 99% of composite fillings are OK. I just have more
>> succesfull amalgam restorations. Etching gel is applied for 30 secs. I
>> can show you several cases of postoperative pain caused by etching... For
>> 30 seconds of course... That's why I place a base first and then etch the
>> tooth if the cavity is deep.
>>
>>> Having said that, I seldom place posterior composites unless I am
>>> treating incipient lesions. I place amalgams for small fillings when
>>> the patient wants the cheapest thing I have. I do tons of posterior
>>> ceramic restorations with total etch which are less than a mm from the
>>> pulp with no base, and the patients report zero sensitivity after
>>> treatment.
>>
>>
>> Well, ceramic restorations are not frequent over here. Only crowns, but
>> inlays ans onlays are abit old fashioned... I don't think we can mix
>> those two up, ceramic and composites. But the etching gel: a mm is very
>> near. Which concentration do you use? This intreages me
>>
>>> I don't mean this to belittle or to say I am better, but to encourage
>>> conversation to improve both you and me.
>>
>>
>> But of course. And I appreciate all feedback as much as you do.
>
>
> --
> Mark & Steven Bornfeld DDS
> http://www.dentaltwins.com
> Brooklyn, NY
> 718-258-5001


.

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