Direct Pulp Cap by Dr. Ahmad Fayad

Posted on May 15 2019

Noteworthy use of the Greater Curve technique by Dr. Fayad.


28 year old female with senstive Upper left first molar #26.

No spontaneous pain, no lingering pain, no pain on vertical percussion.

Diagnosis: Reversible pulpitis with normal periapex





Good isolation is the key

Step 1

After removal of previous leaking composite and caries excavation, I exposed the pulp.

Soaked cavity with full strength bleach for one minute.

Step 2


Pulp cap placed

Step 3

After bleeding control, I apply the pulp cap material. I use Theracal, others use Duralon. In my hands, Theracal has a high success rate.

Greater Curve Standard band in place

Step 4


Post prime and bond

Step 5

After prime and bond (clearfil se protect), I seal the entire margin with a very thin layer of flowable composite (Majesty flow).

Placing composite

Step 6

Place composite in increments. I don't get carried away by placing anatomical features yet. I find when I try to create anatomy with uncured composite, I tend to stretch it creating voids and weak links between layers (others may have different opinions). A nice solid structure is what I aim for now, all packed nicely. Composite: Exquisite from Apex



Step 7



Step 8

Snap contacts

Post op BW

Step 9


Post op PA

Step 10



  • Nathan Mayo: May 16, 2019

    I’ve always wondered why dentists think that curing in increments reduces shrinkage. 1+1+1=3 every time. I like that you sealed the margin with flowable, but I use 1 blob bulk fill with as many balls of precured composite as I can cram down into the mass. A very thick one like this would get 2 rounds of bulk and balls. Cure it all then cut it back. No one but another dentist cares about the nice anatomy and grooves. Good job, and I like your bleach idea. I do that too, during spoon excavation of deep DK where I know I am close to pulp………softens DK and kills bugs on the way in.

  • Tracey: May 16, 2019

    I noticed you have the tofflemire retainer upside down. Does the greater taper work better that way?

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