Pulp Cap utilizing Dr. John Kanca's Technique- By Thomas W. Mitchell, DDS, FAGD

Introduction: 

Asymptomatic #21 with deep decay. I was hoping to leave the affected dentin and not expose the pulp. I tried to remove the last bit of decay stain and there it was. So I got my other world class assistant (where would I be without them???) to get the stuff and away we go……..Here's the procedure:

Thomas W. Mitchell, DDS, FAGD
Thomas W. Mitchell, DDS, FAGD
One of those sneaky small openings, huge area of decay.
Thomas W. Mitchell, DDS, FAGD
Lots of soft "infected" dentin
Thomas W. Mitchell, DDS, FAGD
Decay stain
Thomas W. Mitchell, DDS, FAGD
Oops! Just took the top off. No bleeding. Cleaned it up with weakened bleach (3% solution) on a cotton pellet for about 2min. Rinse and Dry.
Thomas W. Mitchell, DDS, FAGD
Durelon placed over the exposure. We dilute the standard mix with a drop of water so it's easier to apply. You can also get it in Fast Set. This is the regular set and it does take a few minutes to harden sufficiently. (A wet 2X2 can be tented over the exposure to keep the tooth from desiccating while the Durelon sets). From here I do my usual Surpass/Titan/Exquisite fill that I've shown many times. As you can see there's still some "affected" dentin that I intentionally left.
Thomas W. Mitchell, DDS, FAGD
Final x-ray.

Conclusion: 

So far so good on this one. The key is that the tooth must be asymptomatic. If not just start the endo. This case was unusual because of the direct exposure. I usually will stop before that happens. I place Durelon only when I can either see pink dentin, or if there's a direct exposure. The best pulp cap is decayed dentin, so I often leave "affected" dentin. When I do I always make sure that after Surpass 2, or your dentin primer, is dry that the dentin appears shiny. If not I apply more Surpass 2 primer so I know it's sealed in under the resin.

Case by: 

Thomas W. Mitchell, DDS, FAGD