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CASE PRESENTATION: Treatment of Deep Caries of Tooth No. 9 in Adolescent

Categories: Restorative Dentistry


Date: 09-22-2020 07:58:09 am

A 13-year-old girl presented to the practice for her recall visit. Upon examination, we detect­ed caries on the distal of tooth No. 9. A diag­nosis of deep caries was confirmed with x-rays. After discussion of treatment options with the patient’s parents, we chose a minimally invasive approach that included the use of a laser for tooth preparation. 

Tooth preparation was performed using the LiteTouch erbium laser (AMD Lasers). Because of the use of a laser, we were able to complete the tooth prep without any anesthesia. According to proper protocol, we used a total of 2.3 W and low energy combined with air and water. 
Because of the deep preparation required for the caries removal, we needed to provide pulpal protection. One layer of TheraCal LC resin-modified calcium silicate pulp protectant/liner (BISCO) was applied. Each layer was light-cured for 20 seconds. The calcium release* from TheraCal LC makes it stable and durable as a liner. 

Next, using the selective-etch technique, Futurabond U (VOCO) was applied per manufacturer instructions. The application of Futurabond U was followed by 2 increments of Admira Fusion (VOCO) shade A2. The restoration was finished and polished using Gazelle composite polishers (Microcopy). 
The patient and her parents were pleased with the outcome of the treatment. They were especially impressed with the use of the laser to prepare the tooth as well as the excellent esthetics.


TheraCal LC is a light-cured, resin-modified, calcium silicate filled liner designed for use in direct and indirect pulp capping and as a protective liner under composites, amalgams, cements, and other base materials. It can be used as an alternative to calcium hydroxide, glass ionomer, RMGI, IRM/ZOE, and other restorative materials. TheraCal LC performs as a barrier1,2 and protectant of the dental pulpal complex. TheraCal LC’s precise placement allows its use in all deep cavity preparations. The light-cured set permits immediate placement and condensation of the restorative material. Its proprietary formulation allows for a command set with a light-curing unit while maintaining ease of placement due to thixotropic properties. The proprietary hydrophilic resin formulation creates a stable and durable liner.

* BISCO has on file the calcium release data for TheraCal LC.
1. Sangwan P, Sangwan A, Duhan J, Rohilla A. Tertiary dentinogenesis with calcium hydroxide: a review of proposed mechanisms. Int Endod J. 2013;46(1):3-19

2. Savas S, Botsali MS, Kucukyilmaz E, Sari T. Evaluation of temperature changes in the pulp chamber during polymerization of light-cured pulp-capping materials by using a VALO LED light curing unit at different curing distances. Dent Mater J. 2014;33(6):764-9.
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