References

Mertz-Fairhurst EJ, Curtis JW, Ergle JW, Rueggeberg FA, Adair SW. Ultraconservative and cariostatic sealed restorations: results at year 10. J Am Dent Assoc. 1998; 129::55-65
Laurent P, Camps J, About I. Biodentine induces TGF-b1 release from human pulp cells and early dental pulp mineralisation. Int Dent J. 2011; https://doi.org/10:1111/j.1365-2591.2011.01995
Atmeh AR, Chong EZ, Richard G, Festy F, Watson TF. Dentin-cement interfacial interaction: calcium silicates and polyalkenoates. J Dent Res Online. https://doi.org/10:1177/0022034512443068

Technique tips – a ‘get out of jail’ material

From Volume 39, Issue 4, May 2012 | Page 300

Authors

F J Trevor Burke

DDS, MSc, MDS, MGDS, FDS(RCS Edin), FDS RCS(Eng), FFGDP(UK), FADM

Professor of Primary Dental Care, University of Birmingham School of Dentistry, St Chad's Queensway, Birmingham B4 6NN, UK

Articles by F J Trevor Burke

Article

The treatment of deep caries lesions may be fraught with difficulty, and total removal of deep caries in an asymptomatic tooth may result in a pulp exposure. The sealing of caries into the tooth has been suggested following the work of Metz-Fairhurst et al,1 but the recent introduction of a material (Biodentine, Septodont, UK), which has demonstrable dentine repair properties,2,3 may be of value. This material is composed of a purified tricalcium silicate powder which is mixed with water in a capsule, with the reaction releasing calcium hydroxide.

Deep caries was noted on a bitewing radiograph (Figure 1) in a number of otherwise symptom-free teeth in a 22-year-old female patient with high caries activity. The maxillary 1st and 2nd molar teeth tested vital. After removal of wet and infected dentine, it was decided that a pulpal exposure was likely if excavation was to be continued (Figure 2). Accordingly, excavation was stopped and Biodentine placed in the cavities and, after 15 minutes’ setting time, basic carving could be carried out (Figure 3). After 9 months, the restorations were intact (Figure 4) and the tooth symptom free. A decision will be made in due course regarding the need for replacement of the restorations and whether removal of the remaining caries will be carried out, or simply that the restorations be resurfaced with resin composite.

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