A method to restore root caries

Posted on January 28 2019

Introduction:

Great case submitted by Dr. Ahmad Fayd.

I get these root caries frequently, where the occlusal surface is usually intact with a huge defect on the root. In my opinion, to include the occlusal surfaces and make classic class 2 preps for these teeth would weaken them. Here is a great case where I used Greater Curve and created windows.

Step 1

 

Step 2

 

Step 3

 

Step 4

 

Step 5

Coarse diamond used to make the hole in the matrix

Step 6

After prime and bond

After prime and bond - then inject some flowable and snow plow with your favorite composite. In this case I used Majesty flow and Exquisite.

 

Step 7

 

Step 8

Composite cured through the hole

Step 9

After the removal of the matrix, cure again

Step 10

 

Step 11

 

Thanks for reading.

Any thoughts and suggestion would be welcomed!

8 comments

  • Dennis Brown: February 05, 2019

    You can crank on the Greater Curve band and accomplish a very tight subgingival seal. Also, making a hole in the matrix can be done very quickly. Now you have the best of both worlds. Sealed isolated prep and access. I would suggest a Glass Ionomer or a Bioactive composite such as Activa from Pulpdent.

  • Vance Wascom: January 31, 2019

    Good work, I will use this

  • Nathan Mayo DDS: January 31, 2019

    I think Greater Curve is fine in some places, but not here. A Clark’s bowed out clear matrix would have been my choice, and I love Beutifil Flowable for stuff like this. Glass, gorgeous color matching, polishes well…..blah-blah-blah. Still, you did a great service for the patient and if it works good for you then good job ! Consider scrubbing deep DK with chlorine bleach to soften affected dentin and kill bugs + excavate with a sharp spoon. You will be pleasantly surprised, especially when you are close to pulp.

  • Rani: January 31, 2019

    I’m confused as for the purpose of the band in this case

  • Peter Shillingford: January 31, 2019

    Why on earth are you still trying to resist …to struggle with the box -subgingival and upper curve near the marginal ridge when the Palodent system with the smaller matrices of different sizes and shapes and the NiTi clamps will deal with this problem very very efficiently, promptly and correctly. This greater curve is madness!!!!!!!!!!!!! I mean really…puncturing the band…why not burnish the band as we did in the amalgam era….smile!!!!!!!!

  • Stephen Wagner: January 31, 2019

    Really like the technique. I would have probably used a glass ionomer or rmgi here instead of composite. Nice Job!

  • Pierre: January 31, 2019

    If the purpose of the Greater Curve bands in this instance is to provide isolation, does the rubber dam provide more isolation? Just trying to learn.

  • Joseph Heher: January 31, 2019

    Nothing wrong with your technique, but personally I would have used a rapid hard set Glass Ionomer instead of composite. Composite, while it bonds to dentin, the bond isn’t all that great on root axial walls, and there is some degree of fluoride release with the glass as well as a chemical (vs. mechanical) bond to the dentin. Nice to see rubber dam used—almost guarantees a good longer term result. You gave the patient a good service.

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