A 30-Month Follow-Up of Stepwise Excavation without Re-entry with Three Different Biomaterials: A Case Report

Abstract

Background and Aim: Restoration of deepdental caries without pulp exposure is usually challenging for dentists. In order to prevent pulp exposure and subsequent root canal therapy (RCT), indirect pulp capping is usually performed. Stepwise excavation (SE) is a conservative method that canreduce the incidence of pulp exposure and maintain tooth vitality without the need for RCT. Considering the high prevalence of dental caries among the Iranian population, knowledge about this treatment modality canbe beneficial for dentists . Case report : A 23 year-old patient with three deep carious lesions presented toour dental clinic. The teeth had normal responses to thermal tests and percussion. Due tothehighrisk ofpulp exposure following conventional complete excavation of caries, stepwise excavation treatment was done. Three different lining materials (calcium hydroxide, MTA, CEM cement) were used to cover the remaining caries. The teeth were restored using posterior restorative glass ionomer (Fuji9, GC, USA). The teeth were followed weekly inthe first month and then every six months up to 30 months clinically and radiographically. At30-month follow-up, the teethdid not show any sensitivity to cold or percussion,had no spontaneous nocturnal painor irreversible pulpitis symptoms and did not need RCT these signs were all indicative of asuccessful treatment .

Keywords

• Stepwise excavation
• liner
• MTA
• calcium hydroxide
• CEM cement
• pulp exposure
• caries removal