Thank you very much dr.Nasseh for sharing your knowledge. There is a question, why the final restoration should be done after 2 months? not 1 or 3 months.
I've read a study where Fuji VII and silver diamine produced tertiary dentine faster than CaOH. How do you compare bioceramic and those 2 for indirect pulp capping material?
i have two doubts 1. while removing caries how far should we remove 2. radiographically will we know RDT or tertiary dentin wen we do our final filling
Could you use the bioceramic liner followed with Fuji II or Fuji IX, and then place composite on top? Like the Fuji sandwich technique, to eliminate the need to revisit the restoration
Great question. Yes you can. However, we've developed a new product called BC-Liner that's optimized to use with the Putty and will be released at the Chicago Mid-Winter meeting. The purpose of it is exactly the same thing you mentioned. A dual cure material that goes over the Putty and allows a sandwich technique to be applied to the Putty. Meanwhile, you can use a regular Glass Ionomer too. Not as good but acceptable. Cheers! :)
TheraCal is a resin modified bioceramic, which translates into more toxicity and less bioceramic availability (bioceramic is bound in the resin matrix and has less bioavailability.) The resin helps with setting of the material but introduces unnecessary toxicity (like all resins!) Where you need the most biocompatibility, against the pulp, you should use a pure bioceramic and not one that's altered by resin. Combining the resin with bioceramic is not the ideal option.
Sorry for delay. Yes, you can use the same technique for that. The challenge is less the type of cavity for VPT but the difficulty in maintaining a seal with the final restorative material, which is the limiting factor if you can't seal adequately and allow leakage after VPT. This is one of the major causes of failure after VPT (the ability to maintain a microbe free environment).
I didn't fully understand. Once you've sent the patient to the restorative dentist, do they remove all the materials (RRM+Fufi 9) first, and THEN place Fuji as the base and restore the rest with composite?
No, they use the original Fuji IX as base by drilling only 2mm into it and bond an ideal composite to seal the surface. THat's all. The second visit is super quick. Cheers!
Can u pls tell me what are the chief complains of patient in which we have to do indirect pulp capping?? Indications of indirect pulp capping? And if patient complain of pain during cavity removal should we continue to remove carious lesion or we only place caoh and gic in it?
personally I have found that the material used for the cap is slightly less important than the pre-operative diagnosis. In teeth with normal pulp or reversible pulpitis and good isolation, my success rate for indirect pulp caps is very high. I have even had a decent direct pulp caps on teeth with normal pulp or reversible pulpitis end up working out. Not every tooth with deep caries needs non-surgical RCT
MTA is not a final restorative material like Fuji IX. I think you've misunderstood something in this presentation. In this video, we demonstrate the use of EndoSequence BC RRM Paste as liner, then Fuxi IX on top. If you have no access to the RRM Paste then you can instead use MTA. RRM Paste is simply easier to apply than MTA and what's shown in this video.
I'm sorry as we are unable to give electronic consultations. However, if the pulp is necrotic, a pulp cap is not possible. Pulp capping is only feasible for teeth with reversible pulpitis. It appears that you should follow your dentist's advice and have an RCT or remove the tooth. Once the pulp is necrotic, these are the only two options. Regenerative endo has an unpredictable prognosis in multirooted molars, where the root anatomy is complex. Good luck!
Can you do pulp capping and preserve the tooth when a large silver filing just fell out? Can be close to the nerve. I have no pain. Currently, there is a temporary filing right now. -- upper right in the back
@@AANasseh Thank You, I have never been informed of this procedure from any dentist. She only says implant and root canal. Will you test me for pulp capping please?
@@jeannezaks4117 You can get a second opinion at a dental school. Not everyone is a candidate for this. I'm in Boston. If you live here it's fine but it's nto worth a long trip. Just see a local dental school for this testing. Good luck.
1/4 of my tooth is broken and the nerve is exposed (the dentist touched it and it hurt). Would a nerve that is exposed be a candidate for this procedure or is this only for tooth loss 'close to' the pulp? I'd prefer to keep my tooth alive if possible. I have cavit in my tooth for the time being and due to the pandemic dentists are only using a 'drill to kill' not to save. Thanks
It all depends how much of the tooth is remaining and how the tooth is testing; but every day that goes by your chances of a vital pulp therapy dimities rapidly.
Thank you for sharing your knowledge with us , i'm really respect that doctor and It's very useful for me .
Thank you ^ ^
Thank you very much dr.Nasseh for sharing your knowledge. There is a question, why the final restoration should be done after 2 months? not 1 or 3 months.
Thank you doctor it has been very useful
Reaally work fantastic ❤️👍🏼
I've read a study where Fuji VII and silver diamine produced tertiary dentine faster than CaOH. How do you compare bioceramic and those 2 for indirect pulp capping material?
Thanks alot Dr! could you please explain what do you mean by “flash”?
Thank you for your amazing vidoes.you mention RRM many in your videos ..can we have a separate videos about its uses?
Thanks for your proffesional video! It's very useful for me. :-)
i have two doubts 1. while removing caries how far should we remove 2. radiographically will we know RDT or tertiary dentin wen we do our final filling
I really wish my teachers are as good and straight forward as reward as this guy, do you have different videos for different preparation????
Excellent 👍
Could you use the bioceramic liner followed with Fuji II or Fuji IX, and then place composite on top? Like the Fuji sandwich technique, to eliminate the need to revisit the restoration
Great question. Yes you can. However, we've developed a new product called BC-Liner that's optimized to use with the Putty and will be released at the Chicago Mid-Winter meeting. The purpose of it is exactly the same thing you mentioned. A dual cure material that goes over the Putty and allows a sandwich technique to be applied to the Putty. Meanwhile, you can use a regular Glass Ionomer too. Not as good but acceptable. Cheers! :)
What about the product Themacal LC is that ok for pulpcapping then thin vitrebond over that , followed with composite?
TheraCal is a resin modified bioceramic, which translates into more toxicity and less bioceramic availability (bioceramic is bound in the resin matrix and has less bioavailability.) The resin helps with setting of the material but introduces unnecessary toxicity (like all resins!) Where you need the most biocompatibility, against the pulp, you should use a pure bioceramic and not one that's altered by resin. Combining the resin with bioceramic is not the ideal option.
What are your thoughts on Silver Diamine Flouride for this?
Thank you very much, great work
How would we preparate the cavity like caries type 2, to keep the pulp vital.
Sorry for delay. Yes, you can use the same technique for that. The challenge is less the type of cavity for VPT but the difficulty in maintaining a seal with the final restorative material, which is the limiting factor if you can't seal adequately and allow leakage after VPT. This is one of the major causes of failure after VPT (the ability to maintain a microbe free environment).
I didn't fully understand. Once you've sent the patient to the restorative dentist, do they remove all the materials (RRM+Fufi 9) first, and THEN place Fuji as the base and restore the rest with composite?
No, they use the original Fuji IX as base by drilling only 2mm into it and bond an ideal composite to seal the surface. THat's all. The second visit is super quick. Cheers!
Awesome, thanks!
Can u pls tell me what are the chief complains of patient in which we have to do indirect pulp capping?? Indications of indirect pulp capping? And if patient complain of pain during cavity removal should we continue to remove carious lesion or we only place caoh and gic in it?
If it hurts they need another injection to numb it
personally I have found that the material used for the cap is slightly less important than the pre-operative diagnosis. In teeth with normal pulp or reversible pulpitis and good isolation, my success rate for indirect pulp caps is very high. I have even had a decent direct pulp caps on teeth with normal pulp or reversible pulpitis end up working out. Not every tooth with deep caries needs non-surgical RCT
You may be right. More studies in this area comparing materials under similar circumstance is needed to confirm. 👍
Could I use MTA instead of a Fuji base for the final restoration?
MTA is not a final restorative material like Fuji IX. I think you've misunderstood something in this presentation. In this video, we demonstrate the use of EndoSequence BC RRM Paste as liner, then Fuxi IX on top. If you have no access to the RRM Paste then you can instead use MTA. RRM Paste is simply easier to apply than MTA and what's shown in this video.
I'm sorry as we are unable to give electronic consultations. However, if the pulp is necrotic, a pulp cap is not possible. Pulp capping is only feasible for teeth with reversible pulpitis. It appears that you should follow your dentist's advice and have an RCT or remove the tooth. Once the pulp is necrotic, these are the only two options. Regenerative endo has an unpredictable prognosis in multirooted molars, where the root anatomy is complex. Good luck!
Yeah for rubber dam.
Can you do pulp capping and preserve the tooth when a large silver filing just fell out? Can be close to the nerve. I have no pain. Currently, there is a temporary filing right now. -- upper right in the back
Pulp testing is needed. Possible.
@@AANasseh Thank you. Do all dentists perform this procedure?
@@jeannezaks4117 Technically, all dentists should know.
@@AANasseh Thank You, I have never been informed of this procedure from any dentist. She only says implant and root canal. Will you test me for pulp capping please?
@@jeannezaks4117 You can get a second opinion at a dental school. Not everyone is a candidate for this. I'm in Boston. If you live here it's fine but it's nto worth a long trip. Just see a local dental school for this testing. Good luck.
1/4 of my tooth is broken and the nerve is exposed (the dentist touched it and it hurt). Would a nerve that is exposed be a candidate for this procedure or is this only for tooth loss 'close to' the pulp? I'd prefer to keep my tooth alive if possible. I have cavit in my tooth for the time being and due to the pandemic dentists are only using a 'drill to kill' not to save. Thanks
It all depends how much of the tooth is remaining and how the tooth is testing; but every day that goes by your chances of a vital pulp therapy dimities rapidly.
Biodentine
no sound after 1:35 min.