by Dr. Susan McMahon
The patient is a healthy, 28-year-old woman with a very low caries rate. She has had staining in the pits and fissures of posterior molars for many years (Figure 1) and has recently begun to experience sensitivity in her upper left molars.
Visual inspection revealed staining in the pits and fissures of the upper left first and second molars. Traditionally, a clinical exam with a sharp explorer would be performed. Recent findings from light-microscopic studies have confirmed that using a sharp dental probe for occlusal caries detection causes enamel defects. Therefore, dental probing should be considered as an inappropriate procedure and should be replaced by a meticulous visual inspection.1 The CamX Triton (Air Techniques) uses fluorescence to evaluate and calibrate demineralization and decay. In Figure 2 the numerical value (1.6) and color coding indicate incipient enamel caries (blue) with deep enamel caries (red). The deep enamel decay was removed with a disposable #330 carbide bur (Microcopy) and the surrounding incipient enamel decay was prepared with a Fissurotomy Bur (SS White).
The preps were cleaned and rinsed with Consepsis (Ultradent). The enamel was etched with 37% Phosphoric Acid, rinsed and lightly dried and then the adhesive was applied and cured. Placement of ACTIVA BioACTIVE-RESTORATIVE was easy and precise with the bendable applicator tip (Figure 3). The applicator tip was used to carry and drag the material for anatomic placement and very little finishing was needed.
About Dr. Susan McMahon
Dr McMahon, an University of Pittsburgh School of Dental Medicine graduate, is in private practice in Pittsburgh and at University Dental Professionals in Chicago. She is an accredited member of the American Academy of Cosmetic Dentistry, the American Society for Dental Aesthetics, and a fellow in the International Academy of Dental Facial Esthetics. She is the Director of Product Evaluation for Catapult Education and a member of Catapult Speaker’s Bureau. She can be reached at 412.298.2734 or [email protected].