Treatment of Deep Caries of Tooth No. 9 in Adolescent
Dr. Kaminer, an Editorial Advisory Board member for Dental Product Shopper, graduated from the New York State School of Dental Medicine at Buffalo. He subsequently completed a 2-year postgraduate residency in Advanced Dentistry at Northshore Hospital on Long Island. Dr. Kaminer is a noted author, lecturer, and teacher on topics such as laser dentistry, minimally invasive dentistry, and high-tech dentistry. He earned the mastership award from the World Clinical Laser Institute. Dr. Kaminer has two practices on Long Island in New York.
A 13-year-old girl presented to the practice for her recall visit. Upon examination, we detected caries on the distal of tooth No. 9. A diagnosis of deep caries was confi rmed with x-rays. After discussion of treatment options with the patient’s parents, we chose a minimally invasive approach that included the use of a laser for tooth preparation.
Tooth preparation was performed using the LiteTouch erbium laser (AMD Lasers). Because of the use of a laser, we were able to complete the tooth prep without any anesthesia. According to proper protocol, we used a total of 2.3 W and low energy combined with air and water.
Because of the deep preparation required for the caries removal, we needed to provide pulpal protection. One layer of TheraCal LC resin-modifi ed calcium silicate pulp protectant/liner (BISCO) was applied. Each layer was light-cured for 20 seconds. The calcium release* from TheraCal LC makes it stable and durable as a liner.
Next, using the selective-etch technique, Futurabond U (VOCO) was applied per manufacturer instructions. The application of Futurabond U was followed by 2 increments of Admira Fusion (VOCO) shade A2. The restoration was fi nished and polished using Gazelle composite polishers (Microcopy).
The patient and her parents were pleased with the outcome of the treatment. They were especially impressed with the use of the laser to prepare the tooth as well as the excellent esthetics.
Figure 1—Anterior view of missing incisors following accident
Figure 2—iTero Element intraoral digital scan, used for file merge with PreXion CBCT scan
Figure 3—3shape Implant Studio planning software; crown-down planning with virtual teeth and implant location
Figure 4—Occlusal view anterior ridge incision with releasing incisions
Figure 5—Surgical guide in position with sequential drills in place
Figure 6—Implant placed with implant mount using surgical guide; implant placed with depth guide of implant mount shoulder to guide cylinder sleeve