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

درمان دندانهاي پوسيده عميق با احتمال اكسپوژر پالپ به روش Stepwise Excavation بدون ورود مجدد با سه لاينر مختلف : گزارش مورد

Abstract Background and Aim: Restoration ofdeepdental 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 exca-vation (SE) is a conservative method that canreduce the incidence of pulp exposure and maintain tooth vitality without the need for RCT. Considering the high preva-lence 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 asuccess-ful treatment. Key Words: Stepwise excavation , liner , MTA , calcium hydroxide , CEM cement , pulp exposure , caries removal