Treatment of deep carious lesion and preserve the PCD in the best way.

Performed by: Dr. Amr Fathy




#1- Initial situation, deep subgingival caries, the patient reports severe pain related to the tooth no. 46.



#2-Preoperative x-ray showing subgingival caries related to tooth no.46 & mesial decay related to tooth no. 47



#3-gingivectomy to expose the margins & easily placing the rubber dam.



#4-placing gingival retraction clamp in reverse direction to pushing down the rubber dam and give space during composite filling of the mesial cavity of tooth no.47 (Teflon in the pulp chamber ).



#5- clean margin.



#6-palatal view shows calculus in the palatal wall of tooth no.46.



#7-buccal view shows clean smooth margins.



#8-wrapping a wedge with teflon to get more matrix adaption to build the cervical hub .



#9-placing ena ring to get more separation.



#10-caries driven access showing 2 mesial canals.



#11- one orifice for 2 distal canals.




#12-obturation of mesial canals, using heat-treated files to preserve the tooth structure.



#13-obturation of the distal canals.





#14-build occlusal anatomy.

#15-palatal view showing the contact area.




#16- buccal view.





#17-removing the rubber dam to check the occlusion and final polish.




#18-buccal view.





#19-final x-ray showing contact area in the right position and preservation of Peri-Cervical Dentin (PCD).




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