Patient came to our office complaining of slight discomfort upon contact with cold drinks apparently caused by enamel fracture. On radiological examination deep carious lesion was found. Tooth tested negative on percussion. The carious lesion was completely excavated and in the process, the pulp cavity was exposed at the mesial pulp horn site. Pulp was still vital with no major bleeding. Maintenance of pulp vitality by direct pulp capping with a bioactive material has been attempted. Bioactive material have a lower fracture toughness and a higher modulus of elasticity than the tooth so that permanent restoration placement was decided upon along with some cusp shaving. A few days later patient informed us on a follow up call that he had a slightly increased sensitivity to cold but no pain occurred following the procedure. So far so good. Avoiding a root canal treatment on a tooth presenting with deep carious lesion reaching the pulp with bioactive restorative material is reachable goal in some instances.
- Mass of embedded pulp stones is still present in pulp chamber and it must be removed to increase both retention and strength of planned core
- Big chunk of metal must be removed from mesio vestibular root canal
- Patency must be recovered in all 3 blocked canals in order to shape, clean and fill those to the apex