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Teeth with irreversible pulpitis
Partial pulpotomy with Biodentine,
(a) mesio-occlusal deep carious lesion on tooth 36,
(b) after pulp tissue removal and hemorrhage was controlled using cotton pellet soaked with 2.5% NaOCl, (c) Biodentine was placed as a pulp dressing material and base material,
(d) tooth was finally restored with composite resin,
(e) no discoloration of Biodentine partial pulpotomy-treated tooth after 15 months,
(f) preoperative radiograph of tooth 36 showing deep caries and periapical changes,
(g) 8-month postoperative radiograph,
(h) 17-month postoperative radiograph showing hard-tissue barrier formation and normal periapical tissue
Teeth with irreversible pulpitis
Full pulpotomy with Biodentine,
(a) deep occlusal caries exposing the pulp in tooth 46,
(b) application of cotton pellet soaked with 2.5% NaOCl to achieve hemostasis after full pulpotomy,
(c) hemostasis after full pulpotomy to canal orifices,
(d) Biodentine placed over pulp tissue and as base material,
(e) resin-modified glass-ionomer liner placed on top of Biodentine,
(f) resin composite restoration on top of Biodentine,
(g) preoperative periapical radiograph of tooth 46,
(h) immediate postoperative radiograph of tooth 46
a: Preoperative radiograph showing recurrent caries below existing amalgam restorations in maxillary right first and second bicuspids. b: Clinical picture after caries removal. c: Radiograph taken after caries removal, showing close proximity of the cavity walls to the pulp, especially for maxillary right second bicuspid. d: Biodentine was placed as a provisional material to restore both cavities and left in place for 6 weeks. The material has a smooth surface after setting. e: Radiograph after Biodentine placement. f: Biodentine was partially removed to serve as a dentin substitute. g: Radiograph 6 months posttreatment. h: Definitive inlay restorations in place cemented with a dual-cure resin cement. i: Radiograph 1 year posttreatment.
a: Preoperative clinical picture showing fracture of maxillary left first molar. b: Preoperative radiograph showing deep caries in both maxillary left first and second molars in close proximity to the pulp. c: After caries removal the pulp was exposed iatrogenically in maxillary left first molar, whereas a very thin pulp-facing layer of dentin could be observed in the distal area of this tooth, as well as the proximal area of maxillary left second molar. d: Radiograph after caries removal. e: Biodentine was placed as a provisional material to restore both cavities and left in place for 6 weeks. A rubber dam was used to avoid bacterial contamination after pulp exposure. f: In maxillary left second molar Biodentine was then partially removed and kept as a base/dentin substitute that was capped by a direct composite resin filling (Tetric EvoCeram, Ivoclar Vivadent). Maxillary left first molar was prepared for a full-coverage restoration and Biodentine remained as an abutment buildup material. g: Postoperative clinical picture with a direct resin composite filling in maxillary left second molar and a metal ceramic crown in maxillary left first molar. h: Radiograph 6 months posttreatment. No signs of periapical pathology could be observed
Preoperative clinical photograph of existing crown on maxillary right first molar. b: Preoperative radiograph showing recurrent caries at the distal margin of existing crown on maxillary right first molar. c: Clinical status after crown removal and caries excavation. d: Radiograph taken immediately after caries removal, showing close proximity of the cavity walls to the pulp, especially at the distal abutment wall. e: Biodentine was left in place for 6 weeks. During this period the tooth remained symptom-free, whereas its integrity was maintained. f: Radiographic examination at 6 weeks revealed reparative dentin formation and lack of any periapical pathology. g: Final metal-ceramic crown placed after 8 weeks and cemented with conventional glass-ionomer cement (Fuji I, GC). h: Radiographic examination 1 year posttreatment. The tooth remained free from any periapical pathology
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