Pretreatment Data (Partial Excavation)

  • • Patient information: identical to stepwise.
  • • Objective extraoral examination as well as examination of the intraoral soft and hard tissues.
  • • Clinical examination: identical to stepwise.
  • • Radiographic examination: radiographs showing the involved tooth, furcation, periapical area, and the surrounding bone. No apical pathosis is present. The depth of the caries lesion is in pulpal quarter, and starting from half the dentin thickness and into the pulp.

Treatment Protocol (Partial Excavation) [44]

  • • Remove as much of the superficial necrotic and demineralized dentin, so the permanent restoration can be placed.
  • • Final excavation is carried out using hand excavators.
  • • Calcium hydroxide based material and final permanent restoration is placed (Fig. 4.8).
  • • The partial excavation approach has not been systematically examined in adults.
Clinical photographs and radiographs depicting a 1-visit indirect pulp therapy of permanent mandibular left first molar

Fig. 4.8 Clinical photographs and radiographs depicting a 1-visit indirect pulp therapy of permanent mandibular left first molar. (a) Tooth with a deep carious lesion with large accumulations of cariogenic biomasses. (b) Clinical photograph showing the cavity preparation (caries was not completely removed at areas close to the pulp), prior to the final restoration. (c) Clinical view after 1-year follow-up. (d) The pretreatment radiograph shows no apical pathosis, but a deep carious lesion. (e) After 1 year, the radiograph shows no apical radiolucency with successful treatment (Reprinted from Orhan et al. [51]; with permission)

 
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