Monday sometimes gives you bombed out carious lesions that are so deep that you are forced to leave some before inevitable pulp exposure on a 15 year old. You just have to seal it up as well as you can and wait for secondary dentin deposition and hope that the bacteria will be attenuated. It’s not always as satisfying as looking at that radiopaque composite layer right against the pulp, but a sealed non-exposure is always lower risk than a carious exposure. This lesion was sealed up not with GIC, instead opting for a fully bonded solution with an MDP-containing self-adhesive primer (G-Premio Bond, GC). The nanolayering leads to a covalent chemical bond and the creation of an acid-base resistance zone (ABRZ) which is approximately 500-1000 microns which is the “final line of defence” before the pulp is exposed. Superdentin I like to call it. Who knows, I could be going back in in a few weeks to try to remove more caries =) But yes, conservative is better. And on this previously traumatized and phobic patient, this was the right thing to do.
#attenuatecaries #peripheralseal #MDP #AdhesiveDentistry #SuperDentin #GC #PremioBond #SanctuaryBlackLatexDam #AmtechDentalNZ