Cavity Liners

PROTECT THE PULP, placed as thin coatings over exposed dentin Two types of cavity liners: cavity varnish and suspension liner

Cavity Varnish (Solution liner or Copalite)

Natural gum resin dissolved in organic solvent like acetone, chloroform, or ether. Copalite is the most commonly used and reduces initial microleakage --> liner is NOT used under composite because it inhibits the polymerization of the resin Does not act as a thermal barrier. Functions of cavity varnish (solution liner): Reduces marginal leakage to improve the marginal seal for the short term. Prevent acid penetration. Protects pulpal tissues from phosphoric acid in zinc phosphate cements. Prevents mercury penetration into the dentinal tubules from amalgam restorations prevent dentin discoloration.

Under amalgam restorations: improve marginal seal, prevent dentin discoloration, and prevent acid penetration to the pulp from cements Prevent galvanic currents from reaching pulp nor does it completely seal dentinal tubules Short term marginal seal for amalgam.

With any restorative resin, cavity varnish or ZOE is NOT used because they can inhibit polymerization. Using cavity varnish might prevent direct contact between the corn posite and tooth structure, preventing bonding.

Suspension Liner (ZOE & Calcium Hydroxide)

A liquid where calcium hydroxide & sometimes zinc oxide are suspended in natural or synthetic resins. Suspension liners are thicker (15 microns) than solution liners (1-5 microns). Cavity liners (solution and suspension) are being replaced by new dentin bonding agents. Suspension Liner Functions:

Prevents acid penetration and thermal shock and has adequate strength under permanent restorations ZOE: palliative effect on the pulp commonly used for temporary fillings. Calcium Hydroxide (Dycal): most commonly used suspension liner Prevents thermal shock, prevents passage of acid from restorative materials, Enough strength to resist forces. Stimulate secondary dentin formation Easily confused with caries under radiograph as both are radiolucent.

When using the acid-etch technique to restore a Class IV fracture, exposed dentin should first be covered with a calcium hydroxide liner.

Bleaching Teeth
Bleaching Teeth: the most conservative way to lighten VITAL teeth is bleaching.

Two bleaching methods: 1. Office Bleaching: most use a light-activated solution of 35%11202 in 4-10 minute cycles. Other methods to lighten vital teeth: Direct composites which are useful for gray tetracycline-stained teeth. Porcelain Veneers which are useful when the shape, size, and arrangement of teeth are esthetically poor. Full-Coverage Crowns are the most invasive and costly using all-ceramic or a PFM.

2. Home Bleaching: active ingredient in home tooth whiteners with ADA approval 10% carbamide peroxide. The active ingredient in most over the counter home bleaching products is NOT carbamide peroxide, but H2O2 3. Bleaching can affect the color of dentin and enamel. Extrinsic stains respond best to vital bleaching. Yellow stains respond best (then brown and orange stains). The worst response to vital bleaching is gray stains (tetracycline staining).