Afams master Lesson Plan (mlp) Dental Therapist Program 008. 03 Sealers, Bases, and Indirect Pulp Cap



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AFAMS Master Lesson Plan (MLP)

Dental Therapist Program

008.03 Sealers, Bases, and Indirect Pulp Cap



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Instructor

Serial/Semester

Location

Start/Finish Time

Date

LESSON OBJECTIVE

Performance: Place any Pre-Restorative Treatments..
Conditions:

Given: supervision.

Denied: nil.

Environment: classroom / clinic.



Standard:

The Dental Therapist Trainee will place any pre-restorative treatments as required to include: Cavity sealer, Liner, Base, Indirect Pulp cap



  1. Provide pulpal protection

  2. Know the indication of pre-restorative treatments

  3. Instrument selection

  4. Know the classification and functions of pre-restorative treatments

  5. Prepare pre-restorative treatments in accordance with manufacturer’s instructions

  6. Demonstrate application techniques in accordance with manufacturer’s instructions

  7. Managing deep preparations and the proper selection of pre-restorative treatments

  8. Performing an indirect pulp cap




TEACHING POINTS

  1. Provide pulpal protection by:

  1. Understanding the causes of pulp irritation

  2. Conservation of tooth structure




  1. Knowing the indication of pre-restorative treatment

    1. After the preparation of a restoration

    2. Reduction of the post-operative sensitivity




  1. Knowing instrument selection to include but not limited to:

  1. cotton pliers

  2. cotton ball

  3. plastic cotton tip

  4. condensers / pluggers

  5. blunt instrument

  6. Dycal applicator




  1. Knowing the pre-restorative treatment classification, function, preparation in accordance with manufacturer’s instructions and application techniques to include :



  1. cavity sealer

  1. Resin bonding system

  1. Liner

  1. Calcium hydroxide liner

  2. Glass Ionomer liner

  1. Base

  1. zinc-oxide eugenol (ZOE) temporary restorations

  2. Glass Ionomer

  3. zinc phosphate cement

  1. Managing the deep preparations and the proper selection of pre-restorative treatments




  1. Performing an indirect pulp cap by:



  1. Knowing the indications of indirect pulp cap:

  1. Deep caries with no pulp exposure during the preparation of the restoration

  2. the tooth is vital

  1. Knowing the contraindications of indirect pulp cap:

  1. Teeth with a history of spontaneous prolonged pain or painful response to thermal stimuli or percussion

  2. Teeth showing radiographic periapical radiolucencies

  3. Non-vital teeth

  1. Knowing the concept of infected or affected dentin

  2. Knowing the instruments selection this procedure to include:

  1. cotton pliers

  2. cotton ball

  3. plastic cotton tip

  4. condensers / pluggers

  5. blunt instrument

  6. Dycal applicator

  1. Knowing the preparation and application in accordance with the manufacturer’s instructions of

  1. Calcium hydroxide

  2. Glass ionomer

  1. Knowing the clinical steps of an indirect pulp cap include:

  1. Proper tentative diagnostic

  2. Caries removal following the infected/affected caries concept

  3. Placing properly the calcium hydroxide or glass ionomer on affected dentin

  4. Continue with restorative plan

  1. Monitor tooth for symptoms and refer to a stomatology as required

INSTRUCTIONAL STRATEGY

Method: Lecture, demonstrate, practice

Media: Training aids

Environment: Dental Operatory.

OTHER LESSON SPECIFICATIONS

Type of Lesson: Skills Lab

End of Lesson Test: Informal EC

Instructional Time: 120 minutes

Resources: dentaform (dental model), cavity varnish, glass ionomer, CaOH, operative set-up (to include a dycal applicator), cotton pellet, and microbruch.

Reference(s):

The Fundamentals of Operative Dentistry by Summit, et al. ISBN 0-86715-452-7



LESSON PLAN APPROVAL

__________________________________________________________ _______________________

Signature of AHPI Director Date


INTRODUCTION



Allocated Time:

1 Minutes







Objective:

To know when and how to use liners, bases, and perform an indirect pulp cap.







Importance:

This is important to help protect the tooth and increase the longevity of the restoration.









BODY

1. Teaching Point: Apply Cavity Varnish

Allocated Time:

30 Minutes

























PERFORMANCE STEPS:

The Instructor will take a dentoform with a class 1 cavity preparation and demonstrate the application of a cavity varnish such as Copalite by:



    1. Apply two thin coats. A cotton pledget, cut in half, can be used with cotton pliers to wipe or paint all the cavity walls. Air-dry in between the layers to evaporate the chloroform. The second coat ensures that all the dentinal tubules are sealed. The preparation will look shiny or wet.


PRACTICAL – students will use one of the class 1 preparation on the dentaform and duplicate the instructor. The instructor will verify this has been done correctly – this will be the informal EC,

2. Teaching Point: Placing Cavity Liners as Indirect Pulp Cap

Allocated Time:

90 Minutes

PERFORMANCE STEPS:

The Instructor will use a dentaform with class 2 cavity preparation and matrix band /wedge in place. The instructor will show the student how to mix and apply Calcium Hydroxide (Dycal), and Glass Ionomer on both the pulpal floor and then on the axial wall. The Instructor will reinforce that this should only be attempted for INDIRECT PULP CAPPING. The technique is as follows:



  1. The first liner will be the Calcium Hydroxide.

    1. Equal small amounts of base and catalyst are placed on a paper mixing pad and mixed with a spatula within 10 seconds until the paste is smooth and homogeneous.

    2. The mixed material will set in 21/2 to31/2 minutes on the mixing pad (or less if the room temperature is hot).

    3. Work quickly - take a Dycal applicator and scoop up a small amount of the Dycal on the ball of the applicator and apply to the dentine. If you quickly the Dycal will have better flow characteristics.

    4. Avoid touching the margins of the cavity

    5. Avoid placing a large bulk of material

  2. The second liner will be glass ionomer

    1. Mixing instructions:

      1. One level scoop of loosely packed powder to one drop of liquid (must confirm with the specific product you are using)

      2. The powder/liquid ratio of the mix may be varied to change the viscosity needed. Ratios ranging from 1 scoop powder/2 drops liquid to 2 scoops powder/1drop liquid are acceptable.

      3. Rapidly mix (10-15 seconds) all powder and liquid

    2. Placement instructions:

      1. Place in ½ mm increments up to .75 mm thick. Place on dentin only. Do not cover the walls of the preparation.

      2. Light cure for 30 seconds

PRACTICAL – students will use one of the class 2 preparation on the dentaform and duplicate the instructor. The instructor will verify this has been done correctly – this will be the informal EC.

END OF LESSON TEST



Allocated Time:

5 Minutes

Instructions:

The Instructor will simply as the group a following questions

Test Questions or Performance Expected:

    1. Is it OK to have a bulk of Calcium Hydroxide?

    2. Is it OK to put a liner on the margin of a cavity?

    3. True or false – glass ionomer should only be placed on the enamel?

    4. If the room is very hot you have 5 minutes working time for the Calcium Hydroxide

    5. True or False - Indirect Pulp Cap is more predictable than Direct Pulp Cap

Test Key:

1 – NO

2 – NO


3 – False

4- NO


5 – True



CONCLUSION

This is a small part of the restorative procedure but an important part. Take the time to understand the concepts and don’t rush the application of liners.




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