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Biomedical subjects

H M Kopel

Publications and source records attributed to H M Kopel.

30 records · Page 2Linked to original sources
PubMedDate not supplied

Considerations for the direct pulp capping procedure in primary teeth: a review of the literature.

In reviewing the various studies concerning the direct pulp capping procedure in primary teeth, using rigid criteria for case selection and procedure appears to insure a significant amount of success. It is acknowledged that vital primary pulp tissue is capable of healing without resorting to complete pulpectomy, although statistically direct pulp capping has been found to be less successful in primary teeth than indirect pulp therapy or coronal amputation (pulpotomy). To achieve success for direct pulp capping in primary teeth, the considerations involve: selecting teeth with minimal or no clinical signs of pulpal inflammation; or pretreating the carious tooth with a sedative restoration before excavating the caries; disinfecting the cavity floor; enlarging the actual exposure, and flushing out dentinal debris with mild solutions; controlling bleeding by not allowing a clot to form; placing a hard-set, CaOH material over the exposure, followed by a fast-setting, zinc oxide-eugenol cement to achieve a hermetic seal; and lastly, placing a stainless steel crown to minimize microleakage and prevent a fractured or defective restoration. These procedural steps can hardly ensure complete success in direct pulp capping of a primary tooth; but, based on the many cited investigations in this review, a significant amount of success can be expected without resorting more frequently to invasive techniques. Surely the evidence presented leading to the feasibility of direct pulp capping in primary teeth merits further investigations, before dogmatically rejecting this procedure of pulp therapy.

Calcium Hydroxide↗
PubMedDate not supplied

The retentive ability of various cementing agents for polycarbonate crowns.

The following conclusions may be made within the limitations of this investigation. - A composite resin processed directly against a roughened stainless steel dye, similar in shape to a primary anterior tooth, which has been shaped to receive a polycarbonate crown, shows the highest retentive force measured in pounds per square inch (psi). - A polmethacrylate resin, when used as a cement, also shows high values, probably due to its ability to unite chemically with polycarbonated acrylic and to its low film thickness. - Composite resins of low viscosity, low film thickness, and high compressive and tensile strengths proved also to provide good retentive values and would contribute insolubility to a greater degree than the unfilled resin. - Polycarboxylate, zinc phosphate, and reinforced zinc oxide-eugenol cements are not to be recommended as agents for cementing polycarbonate crowns. - It can be recommended on the basis of retention only, composite crowns should be fabricated directly onto the tooth preparations of carious primary anterior teeth.

Carbonates↗
PubMedDate not supplied

The pulp capping procedure in primary teeth "revisited".

The purpose of this review is to "revisit" an earlier paper (1992) on the subject of direct pulp capping in primary teeth and bring some new considerations for the procedure by the use of dentin bonding adhesives. It has come to be recognized that the customary employment of calcium hydroxide for this therapy has some shortcomings that reduce the prognosis for a favorable outcome. For at least a decade, many investigations have found that postoperative sensitivity, thermal stimuli, pulp inflammation and pathosis can be attributed not to the composition of various dental materials and their insertion techniques, but to microleakage with subsequent bacterial invasion at the enamel/restoration and the dentin/pulp interfaces. It is imperative, as pointed out, that there be an impervious resinous bond between the dentin and the dentinopulpal complex which can be achieved by the use of dentinal adhesive agents to eliminate microleakage outward movement of pulpal fluids. Various steps in the bonding technique for the treatment of deep dentin caries and/or a pulp exposure has raised some concerns for their effect on the pulp. This review discusses these concerns, which can lead to the conclusion that the use of dentinal bonding adhesives is a safe and biologically feasible procedure, whether it be in permanent or primary teeth.

Adhesives↗