LINERS AND BASES

Liners and bases are materials placed between dentin (and sometimes pulp) and the restoration to provide pulpal protection or pulpal response.

Pulpal protection requires consideration of :1. Chemical protection. 2. Electrical protection.

3. Thermal protection.
4. Pulpal medication. 5. Mechanical protection.

Clinical judgments about the need for specific liners and bases are linked to the:-

1. Amount of remaining dentin thickness (RDT). 2. Considerations of adhesive materials.

3. The type of restorative material being used.

 Approximately 2 mm of dentin, or an equivalent thickness of material, should exist to protect the pulp.
This thickness is not always possible, but 1 to 1.5 mm of insulation is accepted as a practical thickness. As the tooth preparation extends closer to the pulp, a thick liner or a base is used to augment dentin to the proper thickness range.

Cavity liner:-

Thin layer of cement, that are volatile or aqueous suspensions or dispersions of zinc oxide or calcium hydroxide that can be applied to a tooth surface in a relatively thin film and are used to affect a particular pulpal response.

LINERS
THIN LINERS
( 1to 50 m )

THICK LINERS
( 200 to 1000m )

SOLUTION LINERS
Eg. Varnishes
( 2 to 5m )

SUSPENSION LINERS
Eg. Calcium hydroxide
( 20 to 25m)

Examples of typical liners : Calcium hydroxide. Glass inomer cement. Reinforced ZOE ionomer (IRM).

Function of liners :1. Protect the dentin from residual reactants diffusing out of a restoration and or fluids that may penetrate leaky tooth-restoration interfaces.

2. They also contribute initial electrical insulation.

3. Some thermal protection. 4. Pulpal treatment (sedative or obtudent).

VARNISH
Natural gums(10%) (Copal resin, synthetic resin) + Volatile solvent(90%) (ether, alcohol or acetone)

SEM of one layer of Copalite varnish over smear layer that seals approximately 55% of the tubules.

SEM of two layers of Copalite varnish (80 to 85%).

 Does not posses mechanical strength, thermal insulation.

Varnishes are not used under composite restoration and GIC restorations.

Effects of Varnishes
Seal the dentinal tubules Prevent microleakage Reduce the postoperative sentivity

Bases
Layer of insulating, sometimes medicated, cement, placed in the deep portion of the restoration to protect pulpal tissue from thermal and chemical injury.

BASES
Bases (cement bases, typically 1 to 2 mm) are used to provide : Thermal protection for the pulp( If used >o.5mm). Supplement mechanical support for the restoration by distributing local stresses from the restoration across the underlying dentin surface.

Higher powder/liquid ratio (base or secondary consistency). Cements which are used as bases : Zinc phosphate. Zinc polyacrylate.

Glass ionomer.
Resin-modified glass ionomer, or Compomer cements. A polymer-reinforced ZOE.

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