Abstract

MONARI, Victor; ARSATI, Ynara Bosco de Oliveira Lima  and  RODRIGUES, José Augusto. Avoiding pulp exposure in deep caries lesionsstepwise excavation technique. RGO, Rev. gaúch. odontol. (Online) [online]. 2011, vol.59, n.4, pp. 633-638. ISSN 1981-8637.

In cases of deep caries lesions, total removal of carious tissue can cause accidental pulp exposure, which can be avoided by using the stepwise excavation technique. This consists of the partial excavation of contaminated dentin and the application of a biomaterial, such as calcium hydroxide, with the aim of diminishing progression of the lesion or even arresting it. The aim of the article is to describe a clinical case in which the stepwise excavation technique was performed, relating its advantages, limitations and recommendations. A fourteen-year-old boy reported non-spontaneous pain in tooth 37. The clinical and radiographic examinations indicated an extensive cavity, with a risk of pulp exposure during removal of carious tissue; reversible pulpitis was diagnosed. The stepwise excavation technique was performed. Radiographic examinations performed at 12, 18 and 36 months showed a normal appearance in the apical region and an increase in tertiary dentin was observed. The stepwise excavation technique can be considered a safe therapy, scientifically corroborated, with a high rate of success, however with limited indications, since it requires the teeth to be young and the pulp to present as normal or with reversible inflammation.

Keywords : Dental caries.; Dentin.; Calcium hydroxide..