PMC6757253_01
Intraoral photographs: (a) initial clinical appearance, (b) after pulp tissue removal and haemorrhage was controlled, (c) Biodentine  was placed as a temporary filling, (d) restored with composite resin, and (e) colour stability of the tooth after a five-year follow-up.
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Clinic, Faculty of Dentistry, Chiang Mai University, because of pain in the lower left quadrant upon eating and upon drinking cold liquids. Clinical examination revealed a large carious lesion involving the occlusal and buccal surfaces of the left mandibular permanent first molar (Figure 1(a)). The bleeding was controlled with 2.5% NaOCl-moistened cotton pellets within four minutes (Figure 1(b)). Biodentine  was allowed to initially set for 12 minutes (Figure 1(c)). Finally, the cavity was filled with resin composite (Filtek  Z350 XT; 3M ESPE) and light cured for 40 seconds for each surface, followed by the finishing and polishing procedures (Figure 1(d)). The colour stability of the tooth was noted (Figure 1(e)).
Periapical radiographs recorded (a) before treatment, (b) immediately after treatment, (c) six months postoperative, and (d) five years postoperative, showing dentine bridge and improvement of the periapical area.
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A periapical radiograph showed a deep carious lesion in close proximity to the pulp and periapical lesion, including loss of lamina dura, widened periodontal ligament space, and condensing osteitis (Figure 2(a)). A periapical radiograph was recorded immediately after treatment (Figure 2(b)). The follow-up periapical radiographs showed a dentine bridge and periapical healing (Figures 2(c) and 2(d)).
Bitewing radiographs recorded (a) three years postoperative, (b) four years postoperative, and (c) five years postoperative, showing dentine bridge in the left mandibular permanent first molar.
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Bitewing radiographs at different follow-up periods showed a dentine bridge underneath the Biodentine  layer (Figure 3).