23 yr young female came to my clinic with broken old silver filling. Looking at her tooth condition i advised her x ray to rule out chances of rootcanal treatment.Looking at her x ray even i convinced her for rootcanal treatment, as i was not sure that i can finish it with Indirect Pulp capping treatment. This is done when cavity is in close proximity to pulp chamber of tooth which contains blood vessels and nerves . This pulp tissue provides nutrition to tooth. Since patient is not having any pain and x ray was not showing any signs of infection i advised her that i can save it without doing rootcanal treatment. Final decision will be made after removal of decay portion , if i get sound tooth structure i can do indirect pulp capping. If pulp chamber gets open then i have to do rct as Direct pulp capping is not very predictable . But indirect pulp capping is more predictable as i have treated so many teeth with this treatment option successfully without jumping on RCT. This is the best most conservative way of saving tooth without doing Root canal treatment.
After removal of decay portion when i am working near to pulp tissue i use my hand instruments to remove decay as rotary instruments accidentally will lead to exposure of pulp tissue. Here the decayed portion is very soft and comes out easily with hand instruments .After doing this i found the sclerotic dentin ,its reparative dentine formed beneath the decay portion. From this reparative dentine layer, pulp is hardly less than one mm or very close.
Here restorative materials used routinely for filling cavities can be toxic and can kill pulp tissue. I used GIC light cure material , has fluoride inside . It releases fluoride and arrest further spread of decay. One its done i filled rest of cavity with layering technique to reduce microshrinkage and post operative sensitivity.
Dr Yogesh Pandit
To make people aware about dentistry ,new technology different treatment modalities.To share views about dentistry