PMC4327618_01
Permanent mandibular left first molar with small occlusal enamel caries lesion and slight color change
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A slight color change was noticed through occlusal enamel (Figure 1).
Initial periapical radiograph showing deep caries lesion and normal periapical structures
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No radiolucencies at the periapical regions or thickness of the periodontal spaces were noticed in periapical radiograph (Figure 2).
After cavity access, initial removal of soft carious dentin with excavator
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Excavation was performed carefully to remove only the wet carious dentin (Figure 3), leaving the dry demineralized affected dentin (Figure 4).
View of the cavity floor after removal of infected dentin
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Excavation was performed carefully to remove only the wet carious dentin (Figure 3), leaving the dry demineralized affected dentin (Figure 4).
Dressing of cavity floor with calcium hydroxide paste directly over the affected dentin
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A dressing with calcium hydroxide and distilled water paste was placed directly over the affected dentin on the cavity floor (Figure 5).
Temporary restoration with resin-modified glass-ionomer cement
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After rubber dam removal, occlusion was checked to prevent occlusion stress (Figure 6).
After 60 days, no signs of apical radiolucency or dentin resorption
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No signs of apical radiolucency or dentin resorption were detected (Figure 7).
Recall aspect of the dry remained dentin on cavity floor, after 60 days
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A resin-modified glassionomer cement base placed over a thin layer of calcium hydroxide cement
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Occlusal view of the final restoration with adhesive/resin composite system
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After rubber dam removal, occlusion was checked (Figure 10).
Radiograph showing sound tooth and periodontal structures after 4-year follow-up
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Occlusal view of the restoration after 4 years of follow-up
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