Concluded Case

Proximal caries

Good morning doctors C/C- patient complaint of pain in lower left back tooth region when food lodgement occur. O/E- Distal proximal caries with 36 and 37 x ray shows limited remaining dentin thickness. No continuous pain , pain occurred only when food get stuck. What could be the possible treatment plan

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Though there are no visible periapical changes in both the teeth, but deep carious lesion is approaching pulp, remember destruction shown on radiograph is always less then actual damage. Better to go for RCT of both teeth, however pulpotomy (removal of coronal pulp) of permanent teeth is being experimented and found to be successful, so you may go for same also. Advantages of pulpotomy is vitality of root dentin is preserved which is required for proprioception, For pulpotomy after removal of coronal pulp the heamorrhage should stop easily without clot formation (prerequisite for successful pulpotomy), after that bioceramic or MTA followed by permanent restoration should be planned. If you are going for pulpotomy pls inform patient that if pain occur you might go for RCT

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Along with proximal caries both tooth 36 and 37 have attrition also The occlusal facets have worn off. Hence there is food lodgement and trauma from occlusion. Also there is loss of lamina dura in 36 and periapical abcess is visible which is possible due to TFO Better to go for RCT in 36 and 37.

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Though there are no visible periapical changes in both the teeth, but deep carious lesion is approaching pulp, remember destruction shown on radiograph is always less then actual damage. Better to go for RCT of both teeth, however pulpotomy (removal of coronal pulp) of permanent teeth is being experimented and found to be successful, so you may go for same also. Advantages of pulpotomy is vitality of root dentin is preserved which is required for proprioception, For pulpotomy after removal of coronal pulp the heamorrhage should stop easily without clot formation (prerequisite for successful pulpotomy), after that bioceramic or MTA followed by permanent restoration should be planned. If you are going for pulpotomy pls inform patient that if pain occur you might go for RCT

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Radiolucency involving Enamel , Dentin and also approaching to pul it 36 & 37. Adv- RCT Followed by Crown

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Advice - Root canale treatment w.r.t 36,37 because Pulp involve both teeth

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Advice - both teeth 36,37 go for Root canal treatment

Go rct & build up composit or cap

Iopar show radiolucency involving enamel dentin..wrt 36,37 Adv- RCT followed by crown

RCT irt 36&37

It's better go for RCT as pulp is involve

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@only RCT

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