The Hero – A Case By Dr. Jure Poglajen

The patient is a 30-year-old male presenting with deep caries on the first premolar (tooth #15). Radiographic examination revealed a carious lesion that, although appearing less severe on the X-ray, was significantly more extensive in clinical evaluation. Given the proximity of the lesion to the pulp, endodontic treatment was initially considered. However, after discussing the potential risks and benefits with the patient, we decided to attempt a more conservative approach by restoring the tooth with a bioactive material, which offers a promising chance for pulp preservation.

The carious tissue was meticulously removed, primarily using hand excavators to ensure minimal trauma to the underlying structures. Extreme care was taken to preserve the pulp, and a protective liner was placed to safeguard it during the restoration process. Following this, the standard restorative protocol was followed, including rubber dam isolation, matrix placement, laser etching, adhesive application.

The final restoration demonstrated excellent anatomical form and tight marginal adaptation. Radiographically, the deep restoration is clearly visible, with the liner being discernible to those familiar with its placement, though its opacity is less than that of the restorative material. Despite the depth of the lesion, which was near the pulp, the tooth remained vital, with no signs of pulp involvement. The bioactive material’s release of calcium and phosphate ions may further support the ongoing health of the tooth, promoting remineralization and reducing the need for root canal therapy. As long as the restoration maintains a tight margin and no contact is present, the tooth is expected to remain functional and symptom-free.