REMOVAL OF REMAINING CARIOUS DENTIN OR OLD RESTORATIONS:
It is the elimination of any infected carious tooth structure or faulty restorations left in the tooth after initial cavity preparation.
Caries left in the pulpal/ axial floor is excavated thoroughly making the cavity deeper. 0.75- 1 mm of dentin should cover the pulp. All the infected/ soft dentin should be removed.
Old restorative material should be removed if:
- The material may negatively affect the esthetic result of the new material.
- It weakens the needed retention.
- Secondary caries is present.
- Tooth pulp is symptomatic.
- Periphery of the old restorative material is not intact.
Removal of any Carious tooth structure before restoring a tooth with Restorative materials is a must to prevent any chances of Secondary caries which might arise due to the left over carious tooth structure. Even old restorative materials should be removed if the tooth is being re-restored as in some cases faulty restorations or fractures restorations might have underlying caries which can flare up at any point of time.
During removal of Carious tooth structure or Old restorative material it is important to take a IOPA or RVG radiograph to have a clear idea of the extent of the caries or restoration. This helps in the treatment plan, to decide the type of restoration required, etc.
Dr. Don DiGiulian says
Why aren’t there any photos with these explanations?