Buccal Pit Restoration: Precision in Caries Removal

Age: 26

Gender: Female

Medical History: No significant medical history reported. No known allergies.

Chief Complaint:

The patient presented with a complaint of discomfort and sensitivity in the lower right first molar (tooth 36), particularly when consuming hot or cold foods.

History of Present Illness:

The patient reported experiencing intermittent pain in the lower right first molar for the past few weeks. The discomfort was described as sharp and fleeting, triggered mainly by thermal stimuli. There was no history of trauma to the tooth or recent changes in oral hygiene practices. The patient noted that the tooth had a visible cavity in the buccal pit area.

Clinical Examination:

Visual Inspection: A significant carious lesion was observed in the buccal pit of tooth 36. The lesion was deep, with evidence of discoloration and surface softening.

Palpation: Mild tenderness was noted upon gentle probing of the carious area.

Percussion Test: No significant response indicating pulpitis.

Diagnosis:

Buccal pit caries on tooth 36, with deep carious involvement affecting the dentin. No signs of pulpitis or periapical disease were observed.

Treatment Plan:

Carious Lesion Excavation:

Thorough removal of all carious tissue from the buccal pit of tooth 36.

Careful cleaning of the cavity to ensure complete carious tissue removal and to prevent any remaining infected dentin.

Protective Lining:

Application of a layer of calcium hydroxide (Calcium Hydroxide Base) to the deep portion of the cavity to protect the pulp and promote secondary dentin formation.

Restoration:

Following the calcium hydroxide application, a composite resin was used to restore the tooth. The composite was carefully placed and cured to ensure proper adaptation and seal.

Follow-up:

Schedule a follow-up appointment to monitor the restoration and ensure no post-operative complications.

Discussion:

The presence of buccal pit caries in tooth 36 necessitated a careful and staged approach to treatment. The deep carious excavation required the application of a protective liner to safeguard the underlying pulp tissue. Calcium hydroxide was chosen for its excellent properties in stimulating secondary dentin formation and providing a protective barrier. Composite resin was

selected for its aesthetic benefits and ability to closely match the natural tooth structure.

Restorative decisions considered the extent of the carious involvement and the need for long-term durability. Proper handling of the composite and

ensuring adequate curing were crucial to achieving a successful outcome.

Conclusion:

The treatment of buccal pit caries in tooth 36 involved a meticulous approach to carious tissue removal and the use of a calcium hydroxide liner to protect the pulp. The composite restoration provided an effective and aesthetic

solution for the defect. Follow-up care is essential to monitor the success of the restoration and ensure the longevity of the treatment. Regular dental

check-ups will be crucial to assess the integrity of the restoration and the health of the tooth.