Direct Pulp Capping with the Bio-Bulk Fill Technique

Introduction:

In restorative dentistry, managing carious exposure in deep lesions is a common occurrence, especially in cases with no or mild symptoms. Various treatment options exist, including minimally invasive approaches to vital pulp treatment, such as direct pulp capping.

Direct pulp capping, when conducted after a careful diagnosis, is generally an effective clinical procedure for treating teeth with deep decay and exposed pulp. Calcium silicate-based materials, called bioceramics, are commonly applied in direct contact with the pulp. These materials play a crucial role in eliciting a pulp response and promoting the formation of a reparative bridge of hard tissues, thereby preserving pulp vitality. Additionally, new bioceramics can serve as a dentine substitute and have excellent bonding capacity with resin-based composites, allowing for a one-step cavity filling with satisfactory adaptation to the cavity. This way, the procedure is simplified and the chair time required to complete the restoration is reduced.

This clinical case demonstrates the basic concepts o f the “Bio-Bulk Fill” approach, using Biodentine XP as a dentine replacement, to perform the restoration of a deep cavity lesion.

Grace, 32 years old, presented with a hole in her tooth, but did not report feeling any pain. The tooth was positive in the vitality test and negative in the percussion test. Clinical examination revealed a cavity without exposure of the pulp, and the radiological examination revealed no periodontal lesions.

Case Report