Stepwise excavation in a permanent molar: 17-year follow-up

The current study presents a 17-year clinical report of stepwise excavation and indirect pulp capping in a lower right first molar, with great dentin destruction and a lack of dentin support of the cusps. At the first appointment, indirect pulp capping with calcium hydroxide and a temporary filling with zinc oxide cement were performed to minimize the risk of pulp exposure during excavation. After 45 days, the remaining carious tissue was removed and a restoration with glass-ionomer lining (Vitrebond) and resin composite (P-50) was performed. Satisfactory morphology and function of the restoration and pulp vitality were preserved for 17 years, thus indicating that stepwise excavation can be a good treatment alternative in selected cases.