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The process of cleaning the pits and fissures areas of posterior teeth can be challenging.
Is this the sole cause of caries to develop?
At the same time, these areas are subjected to a great deal of stress. Biomechanics should never be underestimated.It could be hypothesized that the first incident is a enamel crack allowing direct penetration of the bacteria into the DEJ.(Biomimetic Restorative Dentistry, P. Magne, U. Belser)
🔎Let’s examine this case, which initially appears uncomplicated.
The ICD and OCD in the PSZ are clearly visible.In February 2024, we initiated our plan to completely clean the OCD area for this case.At this stage, the pulp area was perforated.MTA was used to cover the perforation area.
After bio base, resin ceramic overlay was used to terminate the case.
In the control performed in July 2024,The indirect restoration of the mandibular mouth in the intense stress area was deemed unsuitable.
Our decision at this point is to use a material that is closer to the elastic modulus of the enamel for the restoration.
ℹ️Modulus of Elasticity (ResinCeramic) 18.28 GPa
ℹ️Modulus of Elasticity(Enamel) 84.1 GPa
ℹ️Modulus of Elasticity(Li-Si) 50-70 GPa
Since the RMGI dentin bonding strength on the MTA applied in February was not appreciated, it was considered to be changed.However, the distal pulp horn was again perforated.It was re-covered with MTA.(In microscope videos, it is possible to view the pulp vascularization)
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