A patient presents to your practice with shooting pain on eating and drinking from the lower left quadrant. She is not able to point out a specific tooth. The pain lasts for an hour and is not relieved by analgesics.
Your oral examination reveals a carious lower left first molar, and there are no sinus tracts or signs of swelling. The tooth is not tender to percussion. Cold testing revealed exaggerated response compared to the second molar, but the pain went away within 30-60 seconds.
You take a radiograph which shows caries reaching the pulp and no apical radiolucency (Figure 1).
The pulpal diagnosis is an irreversible pulpitis and normal apical tissues in the lower left first molar.
This clinical scenario illustrates a common emergency presentation in a dental practice.
A new treatment option for such a case is emerging: performing a full pulpotomy with tricalcium silicates. This technique consists of removing coronal pulp to the level of the canal orifices and achieving haemostasis before placing a biosilicate cement such as MTA or BiodentineTM in the pulp chamber followed by definitive restoration.
Exciting things are happening in the Nation's Network!
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