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Biomimetic Cuspal Rehabilitation Using Indirect Ceramic Onlay After Pulpal Preservation: A Case Report
Ihtisam Alam1, Aravind R Kudva1, S Vidhyadhara Shetty1
1Department of Conservative Dentistry and Endodontics Yenepoya (Deemed to Be University) Dental College Mangaluru Karnataka India.
Background:
Preservation of pulp vitality after pulpal exposure using vital pulp therapy (VPT) is now considered a predictable alternative to root canal treatment for normal or reversible pulpitis. With the growing demand for minimally invasive dentistry, indirect ceramic onlays offer good esthetic outcomes and durability with minimal tooth reduction.
Case Report:
A mandibular left first molar with deep caries was treated with direct pulp capping using mineral trioxide aggregate (MTA). Following initial setting of MTA, immediate dentin sealing (IDS) was performed, and tooth was prepared for an indirect ceramic onlay and was adhesively luted. At 1-year follow-up, the tooth presented normal response to pulp sensibility tests and absence of clinical or radiographic pathology.
Conclusion:
MTA-based direct pulp capping combined with IDS and adhesively bonded ceramic onlay can provide a biologically and mechanically sound alternative to root canal treatment for selected permanent molars with deep caries having pulpal exposures.