Tooth Preparation and Pulpal Response: Literature Review

Öz

Pulp tissue reaction to tooth preparation for direct or indirect restorations is one of the major concerns in fixed prosthodontics. Although the sensitivity of dentine to a variety of stimuli is difficult to correlate with morphological and functional observations, hydrodynamic theory was used to explain dental pain mechanism. External stimuli (e.g., thermal, mechanical and dental restorative processes) applied to human tooth cause either an inward (toward the pulp chamber) or outward (away from the pulp chamber) dentinal fluid flow in dentinal microtubules. A rapid shift of tubule content may activate A and C fibers. Outward dentinal fluid shift is more effective than inward movement to activate mechanoreceptors. Tooth preparations should be performed with use of short grinding intervals and cooling water temperature and special care should be concerned on bur selection because of possible thermal damage to the dental pulp.

Anahtar Kelimeler

• Dentin Sensitivity, Hydrodynamic Theory, Preparation Mine için tampon vazifesi gören dentin, odontoblast hücreleri tarafından oluşturulan mezoderm kökenli bağ dokusudur. Dentin, intratübüler dentinal sıvı ve pulpal sıvı vasıtasıyla pulpa v

Diş Preparasyonu Ve Pulpal Cevap: Literatür Derlemesi

Öz

Diş kesimi sonrası pulpa dokusunda gözlenen duyarlılık sabit protetik uygulamalarda temel bir problemdir. Dentinde çeşitli uyaranlara karşı gözlenen hassasiyeti morfolojik ve fonksiyonel gözlemlerle bağdaştırmak zor olmakla birlikte dental ağrı mekanizması hidrodinamik teori ile açıklanmaktadır. Diş yüzeyine (Isı, mekanik ve restoratif işlemler) iç (pulpa odası yönünde) ya da dış (pulpa odasının ters yönünde) yönlerde uygulanan dış uyaranlar dentin tübüllerinde dentin sıvısının hareket etmesine neden olmaktadır. Tübül içeriğinin hızlı hareketi A ve C fibrillerini uyarabilmektedir. Dış yönde gözlenen direk sıvı hareketi pulpal yöndeki sıvı hareketine kıyasla pulpal mekanoreseptörlerin aktivasyonunda daha etkili olmaktadır. Pulpal dokuda olası termal hasarı önlemek amacıyla, preparasyon kısa aralıklarla ve soğutucu su ile yapılmalı, ayrıca frez seçimine gereken özen gösterilmelidir.

Anahtar Kelimeler

• Dentin Duyarlılığı, Hidrodinamik Teori, Preparasyon

Kaynakça

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