Managing posterior teeth presenting with pulpal involvement and proximal caries is of great challenge. It requires a treatment approach which can restore biologic function of the tooth to a great extent. This case report presents the endodontic treatment and direct Class II Composite restoration of tooth #24 in a 29-year-old patient who presented with deep carious involvement and sensitivity to thermal stimuli. On radiographic examination, it was revealed that the tooth presented with irreversible pulpitis with periapical involvement. This condition of tooth concluded that a root canal treatment is mandatory to ensure tooth integrity. For better treatment outcome, a stepwise clinical protocol was mandatory. This involved access preparation, biomechanical cleaning and shaping, and obturation with gutta-percha was performed under rubber dam isolation. Following successful endodontic therapy, the proximal defect was restored using a direct Class II Composite resin technique. This was done to achieve both functional integrity and anatomical contour of the tooth. An optimal obturation and coronal sealing was confirmed on postoperative radiographs. A follow-up of 6 months was advised to the patient. This follow up would demonstrate resolution of symptoms, radiographic periapical healing and satisfactory functional outcomes.
Ather Hashir (Thu,) studied this question.