Borders College
PAD™ in Caries
Tilo von Samson
Hamburg
Background:
A patient attended with a large number of carious lesions including the deep disto-occlusal cavity on the 36 and a large occluso-lingual cavity on the 37. The bite wing radiograph (Fig.1) showed that the 37 was close to exposure. Vitality testing showed that the 36 was non vital and the tooth was dressed prior to commencement of the endodontic therapy. It was decided to attempt to maintain the vitality of the 37 and restore normally if possible.
Caries was excavated from the 37 until it was decided that further removal would lead to an exposure. Softened caries was left over the pulp. The PADTM technique was then carried out. Photosensitiser solution was applied to the whole cavity and stippled into the softened caries using a brush. After a contact time of 60 seconds the tip of the light guide was placed on the floor of the cavity in the region of the softened dentine and the light activated for 60 seconds.
The cavity was then restored with a dentine adhesive and composite resin.
Fig 2 shows the peri-apical radiograph taken one year later. This shows the restoration to be stable and there appears to be some reparative dentine forming. The tooth remains vital.
The tooth has responded normally to vitality testing for three years.
“Gives more security in root canal treatment. disinfection of the root canal with aseptim now enables the flight crew to be back in the air on the day of treatment; this was not previously possible due to the risk of re-infection.”
Dr Armin Beck Msc. Nato Dentist.
Geilenkirchen, Germany