hello and welcome to chair side life I'm your host Megan strong in today's show
dr. chi is a patient in his chair with severe occlusal decay on tooth number 31
the patient experiences pain when biting as well as sensitivity to cold what to do what
to do well dr. Chi removed the decay placed an indirect pulp cap and then restored with
none other than camouflage flowable and Universal composite let's check out how
it all comes together in this exciting restorative case over to you dr. Chi
for this case we have a patient that has a chief complaint of thermal and pressure sensitivity in
the lower right quadrant our examination reveals severe occlusal decay on 31 the plan is to perform
a caries clean-out and a direct camouflage composite restoration the objective for any
caries removal is to first identify the extent of the decay here I'm using a medium grit round
and tapered diamond to extend the preparation in all directions until I locate uninfected dej you
are able to use any gross reduction burr of your choice because I'm focused on the dej initially
I only have the burr extend to a depth of about two millimeters once a clean dej ring around the
prep is achieved I complete the rest of the carriers removal with a slow-speed round bur
along the axial walls while with light pressure carefully advance apical e I like to use caries
indicator dye as an aid to help guide where a demineralized to structure is but keep in
mind there may also be false positives I see that there's a crack line through the distal
marginal Ridge but since there isn't any signs of leakage or decalcification I like to bond
directly to these areas at a depth of about four millimeters from the occlusal surface
I do begin to see the pulp horns it's best to leave any affected dentin to avoid pulpo
irritation and further complications at this depth I condition the cavity with polyacrylic
acid for 20 seconds and then apply glue ma for a minute we then complete the indirect pulp
cap with a thin layer of Victor bond along the pulp floor now the cavity is ready for bonding
we etch with curse 37% phosphoric acid and follow that with an adhesive application
using three ends scotch bond Universal always use a gentle stream of oil free
air after applying the adhesive until it stops moving this will ensure that the
solvents have fully evaporated and a maximum bond can be achieved I begin the restoration
with a thin layer of camouflage flowable to adapt to the pulp of floor then I build up
the restoration with camouflage Universal a1 enamel the material is very easy to adapt to
the cavity walls and shape to the desired form I place and cure each cusps support individually
I use an explorer also to define at the end the primary anatomy between each cut slow with a
slow speed round bur I'll remove any excess along the margins and adjusts any high occlusal spots
I then finish with some rubber tip composite polishers to achieve a smooth surface we were
able to successfully restore the patient with a direct camouflage resin restoration that's both
strong and provides great natural aesthetics two days after the procedure the patient reached out
to me and told me all of the pain and sensitivity has stopped as a clinician it's gratifying to be
able to take our patients out of pain and address their issues in the least invasive way possible
thanks for tuning in for this episode we'll see you on the next one thank you for that dr. Qi
well that about wraps it up for this episode of chairside live so on behalf of everyone here at
glial laboratories thank you for watching and I'll meet you right back here next time
you