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1、树脂充填技术什么是成功的牙科治疗？n n医生注重的不止是美学的成功，成功的基础是生物学的成功。n n瓷修复体的应用，破坏了过多的牙体组织。n n我们评价一个修复体是最重要的是检查牙龈组织的反应和修复体边缘的密和性。n n治疗牙齿的术后x线片也是同样重要的。复合树脂材料直接修复的适应症n n前牙的牙体缺损（前牙的牙体缺损（，类洞）类洞）n n前牙色泽异常（四环素牙，氟斑牙，牙髓坏死牙）前牙色泽异常（四环素牙，氟斑牙，牙髓坏死牙）的直接贴面修复。的直接贴面修复。n n前牙形态异常（畸形牙，扭转）牙的改型修复前牙形态异常（畸形牙，扭转）牙的改型修复n n前牙小间隙关闭前牙小间隙关闭n n后牙（后牙（
2、，）洞的充填）洞的充填n n双尖牙二类洞和磨牙窄二类洞的修复双尖牙二类洞和磨牙窄二类洞的修复n n制作桩核冠的桩核（树脂核）制作桩核冠的桩核（树脂核）树脂修复的几个步骤n n修复前的准备（清洁牙齿比色）n n牙体预备（隔湿）n n酸蚀（冲洗）n n涂布粘结剂n n分层堆筑n n固化n n外形修整抛光树脂充填工具n n高速手机高速手机n n慢速手机慢速手机n n钻针钻针n n酸蚀剂酸蚀剂n n粘结剂（毛刷）粘结剂（毛刷）n n比色板比色板-树脂树脂n n光固化灯光固化灯n n充填器械充填器械n n打磨抛光器械打磨抛光器械牙体预备-小斜面n n牙体预备后的牙釉质边缘要用橡皮杯抛光-目的是去除悬釉牙
3、釉质边缘更加均一达到良好的边缘封闭作用。n n接触面可做成波浪形贴面的牙体预备边缘设计如何选择？n n树脂贴面平齐牙龈边缘是最佳设计或者使用龈上边缘楔子的作用n n是成型片紧贴牙颈部，有利于邻面牙颈部的形成n n防止充填体形成悬突n n稳固成型片n n分开邻牙以补偿成型片的厚度，使邻牙恢复正常的接触关系粘接剂的选择湿性粘结技术作用原理1.酸蚀:35%磷酸 牙本质脱矿 胶原纤维网外露2.前处理剂:渗透3.粘结:产生混合层和“tags”Singlebond 1两步粘结两步粘结(单瓶粘结剂单瓶粘结剂)n n简单方便的一手操作粘接剂操作过程 窝洞预备 树脂或复合体光照光照酸蚀酸蚀冲洗冲洗轻轻吹干或用干
4、棉球蘸干粘接剂粘接剂/吹干Case Studies:Dr.VargasDr.Marcos VargasFinal result using 3 shades of Filtek Universal Restorative WE(White Enamel)A2D(A2 Dentin)GT(Gray Translucent)Prof.LAMBRECHTS Prof.LAMBRECHTS KatholiekeKatholieke UniversiteitUniversiteit Leuven,Belgium Leuven,BelgiumDr Eric Tan,Melbourne,Australia下
5、切牙严重磨耗用单色制作直接贴面.Supreme XT（）A1E抛光的目的美观性表面光滑咬合关系边缘适应最少的菌斑附着易于菌斑去除1上颌第一磨牙，近中合面。上颌第一磨牙，近中合面。上颌第一磨牙，近中合面。上颌第一磨牙，近中合面。IIII类洞类洞类洞类洞,取代原有银汞修复材料，在操作取代原有银汞修复材料，在操作取代原有银汞修复材料，在操作取代原有银汞修复材料，在操作前先选色，选择前先选色，选择前先选色，选择前先选色，选择A2A2色色色色2将楔子插入邻间隙，用以固定保护邻牙成型片将楔子插入邻间隙，用以固定保护邻牙成型片将楔子插入邻间隙，用以固定保护邻牙成型片将楔子插入邻间隙，用以固定保护邻牙成型片3
6、牙体预备时用成型片保护邻牙，尤其是邻面接触区牙体预备时用成型片保护邻牙，尤其是邻面接触区牙体预备时用成型片保护邻牙，尤其是邻面接触区牙体预备时用成型片保护邻牙，尤其是邻面接触区4用金刚沙钻去处银汞合金，并保持窝洞内的点线角圆钝用金刚沙钻去处银汞合金，并保持窝洞内的点线角圆钝用金刚沙钻去处银汞合金，并保持窝洞内的点线角圆钝用金刚沙钻去处银汞合金，并保持窝洞内的点线角圆钝5用龋蚀显示液用龋蚀显示液用龋蚀显示液用龋蚀显示液.6清洗窝洞后，进行喷沙清洗窝洞后，进行喷沙清洗窝洞后，进行喷沙清洗窝洞后，进行喷沙 40psi(5040psi(50m m m mmm颗粒颗粒颗粒颗粒).).7可以用细沙条清洁牙
7、齿的邻面可以用细沙条清洁牙齿的邻面可以用细沙条清洁牙齿的邻面可以用细沙条清洁牙齿的邻面.8使用符合解剖形态的成型片使用符合解剖形态的成型片使用符合解剖形态的成型片使用符合解剖形态的成型片PalodentPalodent，用楔子将其固定在正确的位置用楔子将其固定在正确的位置用楔子将其固定在正确的位置用楔子将其固定在正确的位置上上上上.9用用#2 Tactile环确保边缘脊形成环确保边缘脊形成10调和调和调和调和 3M3M VitrebondVitrebond 光固化玻璃离子垫底材料光固化玻璃离子垫底材料光固化玻璃离子垫底材料光固化玻璃离子垫底材料 (1(1勺粉和勺粉和勺粉和勺粉和1 1滴液滴液滴
8、液滴液).).用用用用 Hu-Hu-FriedyFriedy F4 F4 探针在窝洞低垫一薄层玻璃离子，光照探针在窝洞低垫一薄层玻璃离子，光照探针在窝洞低垫一薄层玻璃离子，光照探针在窝洞低垫一薄层玻璃离子，光照3030秒秒秒秒.玻璃离子垫底材料的使用玻璃离子垫底材料的使用 n n优点优点n n1.氟离子释放n n2.无需酸蚀.n n3.张力缓冲n n为了减少树脂聚合收缩时产生的张力,在树脂充填时使用玻璃离子垫底.这种张力被垫底材料的缓冲已经被口外试样证明n n 11垫底材料光固化完成垫底材料光固化完成垫底材料光固化完成垫底材料光固化完成.13用水冲洗直到蓝色消失后再持续增长秒用水冲洗直到蓝色消
9、失后再持续增长秒用水冲洗直到蓝色消失后再持续增长秒用水冲洗直到蓝色消失后再持续增长秒12用用用用 3M3M ScotchbondScotchbond 酸蚀剂酸蚀釉质和暴露的牙本质，等待酸蚀剂酸蚀釉质和暴露的牙本质，等待酸蚀剂酸蚀釉质和暴露的牙本质，等待酸蚀剂酸蚀釉质和暴露的牙本质，等待1515秒秒秒秒.14冲洗后的牙齿冲洗后的牙齿冲洗后的牙齿冲洗后的牙齿.15用海面擦去残留的水用海面擦去残留的水用海面擦去残留的水用海面擦去残留的水.16牙面呈湿润并切不过分干燥牙面呈湿润并切不过分干燥牙面呈湿润并切不过分干燥牙面呈湿润并切不过分干燥.17均匀连续涂两层均匀连续涂两层均匀连续涂两层均匀连续涂两层
10、3M3M Single Bond Single Bond 粘合剂粘合剂粘合剂粘合剂 18每次涂粘合剂时，都应使刷头的粘合剂饱和每次涂粘合剂时，都应使刷头的粘合剂饱和每次涂粘合剂时，都应使刷头的粘合剂饱和每次涂粘合剂时，都应使刷头的粘合剂饱和19轻轻吹干轻轻吹干轻轻吹干轻轻吹干.21将将将将3M3M FiltekFiltek Z250 Z250 通用型树脂首先充填在鹫尾处通用型树脂首先充填在鹫尾处通用型树脂首先充填在鹫尾处通用型树脂首先充填在鹫尾处.注意龈阶处的边注意龈阶处的边注意龈阶处的边注意龈阶处的边缘，用缘，用缘，用缘，用Thompson Tactile GTX No.12 and No.
11、15Thompson Tactile GTX No.12 and No.15成型片和环成型片和环成型片和环成型片和环22光固化光固化光固化光固化2020秒秒秒秒.23用牙周探针检查窝洞的深度，确定树脂分几次充填用牙周探针检查窝洞的深度，确定树脂分几次充填用牙周探针检查窝洞的深度，确定树脂分几次充填用牙周探针检查窝洞的深度，确定树脂分几次充填.24 直接充填直接充填直接充填直接充填FiltekFiltek Z250 Z25025充填合面，用充填合面，用充填合面，用充填合面，用 Tactile GTX No.12 and No.5.Tactile GTX No.12 and No.5.成行片帮助邻
12、面充填成行片帮助邻面充填成行片帮助邻面充填成行片帮助邻面充填26每每每每 2.5mm2.5mm树脂光照树脂光照树脂光照树脂光照2020秒秒秒秒27最后一次最后一次最后一次最后一次 FiltekFiltek Z250 Z250充填后充填后充填后充填后.用用用用 Hu-FriedyHu-Friedy CVSA(F6)CVSA(F6)进行合面塑行进行合面塑行进行合面塑行进行合面塑行雕刻雕刻雕刻雕刻 后再光照固化后再光照固化后再光照固化后再光照固化.28光照光照20秒秒.29用用用用3M3M Sof-LexSof-Lex 超薄抛光盘去除邻面多余的树脂超薄抛光盘去除邻面多余的树脂超薄抛光盘去除邻面多余的
13、树脂超薄抛光盘去除邻面多余的树脂.为保护邻牙应保为保护邻牙应保为保护邻牙应保为保护邻牙应保留成型片留成型片留成型片留成型片30在窝沟处上褐色后完成在窝沟处上褐色后完成在窝沟处上褐色后完成在窝沟处上褐色后完成31操作完成后立即除去橡皮障操作完成后立即除去橡皮障操作完成后立即除去橡皮障操作完成后立即除去橡皮障32完成完成完成完成Postoperative Sensitivity术后敏感TheoryDirectIndirectSwitchboardHome影响因素n nTheoryTheoryn nDirect bonding procedures Direct bonding procedures
14、 直接粘接直接粘接Adhesive considerations Adhesive considerations 粘接剂因素粘接剂因素Placement techniques Placement techniques 充填技巧充填技巧Polymerization contraction Polymerization contraction 聚合收缩聚合收缩n nCementation procedures Cementation procedures 冠桥粘接冠桥粘接Cementation vs.bonding Cementation vs.bonding 粘固和粘接粘固和粘接n nRecom
15、mendations from the podium Recommendations from the podium 建议建议Possible causes of sensitivity:术后敏感的可能原因n nPre-existing conditions of the tooth(e.g,cracks)Pre-existing conditions of the tooth(e.g,cracks)牙齿的自身条件（如隐裂）牙齿的自身条件（如隐裂）n nPreparation design Preparation design 预备体设计预备体设计n nIsolation of the bon
16、ding site Isolation of the bonding site 粘接时的隔湿粘接时的隔湿n nOveretchingOveretching of enamel and dentin of enamel and dentin 釉质和本质的过度酸蚀釉质和本质的过度酸蚀n nDentin bonding-proper time and applicationDentin bonding-proper time and application本质粘接本质粘接 正确的时间和步骤正确的时间和步骤n nCuring of the restoration and shrinkage of th
17、e Curing of the restoration and shrinkage of the resin resin 树脂的聚合收缩和固化树脂的聚合收缩和固化n nOcclusal forces Occlusal forces 咬合力咬合力Sensitivity:敏感性n nFluid movement through the Fluid movement through the dentinal tubules results in the dentinal tubules results in the sensation of pain.sensation of pain.液体沿牙本质
18、小管液体沿牙本质小管移动导致疼痛敏感移动导致疼痛敏感n nFluid flow can be Fluid flow can be causedcaused by.by.Evaporative loss(Evaporative loss(dessicationdessication)液体挥发液体挥发 Chemical dehydration(e.g.,Chemical dehydration(e.g.,improper mix of traditional GI improper mix of traditional GI cements)cements)有机溶剂脱水有机溶剂脱水 Osmotic
19、 forces(e.g.,sugar)Osmotic forces(e.g.,sugar)渗透压渗透压 Biting forces on poorly Biting forces on poorly bonded restorations bonded restorations 粘接不良粘接不良处的咬合力处的咬合力n nBut flow requires open dentinal But flow requires open dentinal tubules.tubules.但是液体流动需要牙本但是液体流动需要牙本质小管的打开质小管的打开Opening dentinal tubules:打开
20、牙本质小管n nA variety of events can open the dentinal A variety of events can open the dentinal tubules.tubules.有许多因素可以打有许多因素可以打有许多因素可以打有许多因素可以打开牙本质小管开牙本质小管开牙本质小管开牙本质小管 Acid etching Acid etching 酸蚀酸蚀 Over finishing Over finishing 过度预备过度预备 Cracked tooth syndrome Cracked tooth syndrome 釉质发育不全釉质发育不全 Acidic
21、 cements Acidic cements 酸性的水门矴酸性的水门矴 Cervical erosion Cervical erosion 颈部缺损颈部缺损n nThus sealing these opened tubules Thus sealing these opened tubules becomes of paramount importance!becomes of paramount importance!封闭打开的牙本质封闭打开的牙本质封闭打开的牙本质封闭打开的牙本质小管极为重要小管极为重要小管极为重要小管极为重要smear plugdentinal tubuleSeali
22、ng problems:n nWhat affects sealing?What affects sealing?影响封闭的因素影响封闭的因素 Desiccation during bondingDesiccation during bonding粘接过程中过度干燥粘接过程中过度干燥 Bonding technique Bonding technique 粘接技术粘接技术 Bonding to deep dentin Bonding to deep dentin 粘接深部的牙本质粘接深部的牙本质 Polymerization stress resulting in interfacial Po
23、lymerization stress resulting in interfacial damagedamage聚合收缩力对粘接界面的破坏聚合收缩力对粘接界面的破坏 Cementation procedure(and choice of cement)Cementation procedure(and choice of cement)冠桥粘接过程（对粘接剂的选择）冠桥粘接过程（对粘接剂的选择）Over finishing(removing sound dentin)Over finishing(removing sound dentin)过度预备（去除健康的牙本质）过度预备（去除健康的牙本
24、质）Root surface sensitivityRoot surface sensitivity根面敏感根面敏感Recommended techniques for retaining surface moisture:推荐保持牙齿表面湿润的方法推荐保持牙齿表面湿润的方法n nRemove excess water via Remove excess water via blottingblotting用棉球去除多余的水份用棉球去除多余的水份n nRemove excess water via Remove excess water via suctionsuction用吸引器去除多余的水
25、份用吸引器去除多余的水份n nJudicious use of air-syringeJudicious use of air-syringe有技巧的使用三用枪有技巧的使用三用枪n nUse air-syringe and then Use air-syringe and then rehydrate(use water or rehydrate(use water or desensitizing solution)desensitizing solution)用三用枪吹干后再湿润（用水或用三用枪吹干后再湿润（用水或对光不敏感的溶剂）对光不敏感的溶剂）Video courtesy of Dr
26、.James Dunn护髓及垫底材料的选择n n接近牙髓的地方，牙本质厚度不足1MM可以应用氢氧化钙制剂护髓。氢氧化钙护髓制剂上层要使用垫底材料，最后充填材料。氢氧化钙护髓制剂上层要使用垫底材料，最后充填材料。氢氧化钙护髓制剂与牙本质结合性较差，只有氢氧化钙护髓制剂与牙本质结合性较差，只有38MP38MP，抗压强度比较差，抗压强度比较差，抗细菌溶解性较差，产品偏酸性，不建议直接在树脂下垫底使用。抗细菌溶解性较差，产品偏酸性，不建议直接在树脂下垫底使用。n n牙本质1MM以上的时候，可以直接使用玻璃离子基的垫底材料。玻璃离子基的垫底材料，与牙本质有很好的化学粘接性，而且与上层充玻璃离子基的垫底材
27、料，与牙本质有很好的化学粘接性，而且与上层充填用的树脂材料也有很好的结合性。填用的树脂材料也有很好的结合性。玻璃离子材料要求具有强的抗压强度，高的抗细菌性和低的溶解性。玻璃离子材料要求具有强的抗压强度，高的抗细菌性和低的溶解性。玻璃离子偏酸性，不会影响树脂充填前的酸蚀处理。玻璃离子偏酸性，不会影响树脂充填前的酸蚀处理。The problem of deep dentin:深龋洞的问题n nOne popular One popular solution:use a solution:use a liner/base in deep liner/base in deep restorations
28、restorationsYamada;1983Towards Pulp Chamber髓腔方向Use of stress relieving liner/bases:使用垫底材料进行缓冲Video courtesy of Dr.James DunnConclusions:结论Recommendations From the Podium.n nCommon themes that you will hear include.Common themes that you will hear include.Isolate your field!Isolate your field!隔湿隔湿 Ke
29、ep the dentin moist!(or remoisten before bonding)Keep the dentin moist!(or remoisten before bonding)保持牙体保持牙体湿润湿润 Use a desensitizing agent.(benefit might be in the rewetting Use a desensitizing agent.(benefit might be in the rewetting aspects of this step)aspects of this step)用处理剂进行再湿润用处理剂进行再湿润n nBe
30、 careful,however,as some rewetting agents can reduce Be careful,however,as some rewetting agents can reduce bond strength with some adhesives or cementsbond strength with some adhesives or cements Use a liner in large posterior restorationsUse a liner in large posterior restorations后牙大窝洞要垫底后牙大窝洞要垫底n
31、 nRMGIRMGI树脂加强型玻璃离子树脂加强型玻璃离子n nFlowable Flowable 流动树脂流动树脂 Use a RMGI cement whenever indicated Use a RMGI cement whenever indicated 尽量用树脂加强玻璃离子尽量用树脂加强玻璃离子 Less invasive Less invasive 减少刺激减少刺激n nSimple(less variable)and easy cleanup Simple(less variable)and easy cleanup 易于清理易于清理n nHigher initial pH t
32、han conventional GI Higher initial pH than conventional GI 固化时的固化时的PHPH值值高于传统玻璃离子高于传统玻璃离子Keep the dentin moist!保持牙体湿润Use a desensitizer to rehydrate(or water,dentin primer,etc,)用水，前处理剂等进行再湿润用水，前处理剂等进行再湿润Use RMGI cements for metal,pfm,and Procera(R)restorations使用树脂加强型玻璃离子粘接使用树脂加强型玻璃离子粘接Use a liner/ba
33、se or flowable in large posterior restorations.后牙大充填物要垫底后牙大充填物要垫底Maintain isolation!保持有效隔湿More Recommendations.n nAllow a few seconds for the dentin adhesives to saturate Allow a few seconds for the dentin adhesives to saturate the collagen network before drying.the collagen network before drying.干燥
34、前留出时间让粘接剂使胶原纤维网再湿润。干燥前留出时间让粘接剂使胶原纤维网再湿润。干燥前留出时间让粘接剂使胶原纤维网再湿润。干燥前留出时间让粘接剂使胶原纤维网再湿润。n nConsider additional coats of adhesives in certain situations.Consider additional coats of adhesives in certain situations.在有些情况下可再涂抹一层在有些情况下可再涂抹一层在有些情况下可再涂抹一层在有些情况下可再涂抹一层 粘接剂粘接剂粘接剂粘接剂 In posterior restorations this
35、helps ensure complete In posterior restorations this helps ensure complete sealing.sealing.对于后牙充填，这样可以确保更好的封闭性对于后牙充填，这样可以确保更好的封闭性对于后牙充填，这样可以确保更好的封闭性对于后牙充填，这样可以确保更好的封闭性n nUse a surface sealer after finishing.These can help in the Use a surface sealer after finishing.These can help in the case of crac
36、ked enamel or open margins,as well as fill case of cracked enamel or open margins,as well as fill finishing-induced composite defects.finishing-induced composite defects.使用表面封闭剂使用表面封闭剂使用表面封闭剂使用表面封闭剂n nQuestions?Questions?请提问请提问Let adhesives saturate the etched dentin.让粘接剂再湿润牙本质In deep-dentin use add
37、itional adhesive深窝洞可多涂抹一层粘接剂Surface sealers have multiple advantages!表面封闭剂可带来许多优点Vitrebond Light Cure Glass Ionomer Liner/BaseClinical Technique MovieVitrebond光凝垫底玻璃离子 Resin modified GIC双重固化working time 3 minsetting time 30 secfluoride releasehigh adhesionbiocompatibleradioopaqueCross-section of an
38、amalgam restoration.Vitrebond liner/base seals dentin preventing dye penetration between the dentin the liner/base.Vitrebond Light Cure Glass Ionomer Liner/BaseFeatures特点 韧性好，而且有一定弹性的垫底韧性好，而且有一定弹性的垫底材料材料 杰出的操作手感使使用非常杰出的操作手感使使用非常 Resistance to leakageResistance to leakage 3M3M ESPE ESPE VitrebondVitr
39、ebond liner/base reduces liner/base reduces microleakage which microleakage which helps reduce tooth helps reduce tooth sensitivity when used sensitivity when used under restorative under restorative materialsmaterials3M ESPE Vitrebond liner/base sustained fluoride release High and High and sustaine
40、d sustained fluoride releasefluoride releaseVitrebond Light Cure Glass Ionomer Liner/BaseFeatures(continued)Excellent clinical retentionExcellent clinical retention In a clinical study,the In a clinical study,the Class V restorations lined Class V restorations lined with 3Mwith 3M ESPE ESPE Vitrebon
41、dVitrebond liner/base liner/base demonstrated 100%demonstrated 100%retention at the three-retention at the three-year recall periodyear recall period“Clinical Evaluation of“Clinical Evaluation of Class V Abrasion/Erosion Class V Abrasion/Erosion Lesions”J Dent Res 71(Spec Lesions”J Dent Res 71(Spec
42、IssIss:705):705)A light-cured,hybrid glass ionomer liner/base that has high,sustained fluoride release,bonds to tooth structure,and is biocompatible.Vitrebond Light Cure Glass Ionomer Liner/BaseFeatures(continued)High bond strength High bond strength to dentinto dentinVitrebond Light Cure Glass Iono
43、mer Liner/BaseFeatures(continued)Antimicrobial actionAntimicrobial action Produces zones of Produces zones of inhibition against inhibition against bacteria in laboratory bacteria in laboratory testing testing Bacteria can increase Bacteria can increase the chance of post-op the chance of post-op se
44、nsitivitysensitivity Excellent Excellent performance under performance under both direct and both direct and indirect restorationsindirect restorations Convenience of a single Convenience of a single liner/base that works liner/base that works well under composite,well under composite,amalgam,cerami
45、c and amalgam,ceramic and metal restorationsmetal restorations Excellent bond with Excellent bond with 3M3M ESPE ESPE dental dental adhesive systems adhesive systems Vitrebond Light Cure Glass Ionomer Liner/BaseFeatures(continued)Vitrebond Light Cure Glass Ionomer Liner/BaseIndications A liner/base
46、for use A liner/base for use under:under:CompositesComposites AmalgamsAmalgams Cast restorationsCast restorations CeramicsCeramicsVitrebond Light Cure Glass Ionomer Liner/BaseStep 1 Step 1-Mix one level scoop of powder with drop of liquid.-Mix one level scoop of powder with drop of liquid.Vitrebond
47、Light Cure Glass Ionomer Liner/BaseStep 2Step 2-Apply in a thin layer(1/2mm or less),covering dentin.-Apply in a thin layer(1/2mm or less),covering dentin.Vitrebond Light Cure Glass Ionomer Liner/BaseStep 3Step 3-Light cure for 30 seconds and youre assured of a hard set.-Light cure for 30 seconds an
48、d youre assured of a hard set.If needed,a second layer up to 2mm may then be placed and If needed,a second layer up to 2mm may then be placed and cured.cured.Vitrebond Light CureGlass Ionomer Liner/BaseTechnique GuideAlkalinerTM MiniTipAlkalinerTMTM MiniTipCalcium hydroxide=hydrated limeChemical for
49、mula:Ca(OH)2 highly alkaline,pH=12Calcium Hydroxide PastesPrincipal indications:l direct pulp cappingl indirect pulp cappingTherapeutic compounds for medical insert to protect the pulp against chemical and thermal damagesBlatt 4Therapeutic Measures for Keeping the Pulp Vitall Direct capping:Material
50、 will be applied directly onto the exposed pulp l Indirect capping:Pulp is not exposed,material will be applied nearby the pulpWhat is AlkalinerTMTM MiniTip?l Calcium hydroxide cement in MiniTip cartridges for long-term therapeutic pulp protection.l Alkaliner is eugenol free,and therefore suitable f