Applications pulp capping

Pastes of calcium hydroxide with water have been used as pulp-capping materials for many years and it is the material of choice for this application (Granath, 1982). Its favourable tissue responses have been known for many years (Zander, 1939). It has a healing effect, for it induces the formation of hard tissues of reparative dentine when pulp has been exposed (Eidelman, Finn Koulourides, 1965). This action seems to be associated with its high alkalinity (pH 12-5) and consequent bactericidal and proteinlysing effect (Fisher, 1977). 

When hardened. Biodentine shows good biocompatibihty with the oral tissues and, in particular, exerts minimal influence on cells of the adjacent pulp. Some loss of cell viability has been reported, but this has been attributed to apoptosis and necrosis, rather than the toxicity of the material [71]. In one study of the performance of Biodentine, it was found that the material caused complete dentinal bridge formation in molars while creating no inflammatory response on the cells of the pulp [72]. Both of these features suggest that this material has promise for application in pulp capping. Its ability to promote regeneration of the hard tissue is particularly noteworthy, and will be considered in more detail in Chapter 9. 

As well as being used for direct and indirect pulp capping, calcium hydroxide materials are recommended for nse in deep cavities. This is similar to their use in indirect pulp capping, but implies that all of the carious dentine has been removed, leaving behind a thin layer of sonnd caries-free dentine. Even in this circumstance, the high alkalinity of calcinm hydroxide materials is able to stimulate further dentine formation [41,43,44]. Their application where remaining sonnd dentine is thin will ensure that it does not remain thin. Instead, it will thicken in sitn nnder the influence of the calcium hydroxide to form an improved layer of dentine that is better able to protect the pulp from diffusion of monomers from repair materials or from the effects of bacterial penetration. This process takes time, with typically approximately 2 months time being need to form 0.1 mm of reparative dentine. 

Literature provided by the manufacturers suggests that Biodentine can be used for various applications, not only for pulp capping but also for other endodontic applications, such as repair of pulp chamber floor perforations and of lateral root perforations [95]. It can also be used for indirect pulp capping and to line deep carious lesions. However, to date systanatic smdies are lacking, and there is only limited evidence of clinical success of Biodentine in these applications. Early published results are promising, but more work is necessary before a definitive opinion on this material is possible [95]. 

The EU ETS cap and trade scheme is calculated to accord with the principles of the Kyoto Protocol. The scheme, which is currently in the 2008-2012 phase called the Kyoto Phase is applicable to approximately 10,000 industries that include, but are not limited to oil drilling and refining, manufacture of ceramic glass and cement products, fossil fuel based energy production pulp, paper and textile manufacture, issues each industry with an allocation or quantity of allowances, each of which allows the concerned industry to emit one million metric tonnes of carbon dioxide. The quantification is based on what are called historical aviation emissions that are defined as the mean average of the annual emissions in the calendar years 2004, 2005 and 2006 from aircraft departing or arriving from a member State of the EU . 

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