Accessible Version
Robert C. Clay, Jr., DDS, Ltd.

Deep Decay in a Molar with a Bioactive Protective Liner and White Composite Filling

Tooth decay is a softening of tooth structure.   Sometimes we see it after there is a large hole, and other times it presents as a small softened pit, or even something that only shows up on an x-ray.  The important thing is making sure we remove all of the decay so it doesn't continue to get deeper an cause further problems.  In this case we have a tooth that is intact for the most part, and just presented as a soft spot in a pit, as well as some discoloration as you can see in the pre-op photo.  We opened up the small pit and found the decay had spread quite a bit under the surface of the enamel.  We went as conservatively as possible and cleaned out all of the decay. Once it was all cleaned out, we then decide how to restore it.  In this case, the walls around the decay are on the thinner side but still intact. The decay was also quite deep towards the nerve in the tooth.  Thin walls  make us consider restoring with things like crowns or onlays.  Deep decay leaves us concerned with the health of the nerve going forward.  So, in this case, we decided to go conservative and we placed a bioactive liner on the deepest part of the cavity.  This material stimulates the nerve chamber to try to heal and frow some repairitive dentin within the nerve chamber.   With that, we are trying to avoid root canal therapy.  After the liner was placed, we placed a conventional white composite filling material to restore the tooth.  We are leaving this thinner wall for now and we want to give the tooth time to see if there is any potential nerve problems going forward.  We can then decide if a root canal is needed or not BEFORE a new crown would be made.  Then, after some time, we can decide if we want to place a crown on the tooth, or if we want to leave it as it is with this filling. 

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