In deep carious lesions, the carious potential of bacterial biofilm rises with acidogenic by-products of bacterial metabolism initiating enamel demineralization and stimulating defensive reactions in the dentine and pulp, such as increased intra-tubular dentine and initial inflammation. If the demineralization of enamel continues to progress, dentine will be exposed to bacterial inva-sion, which leads to further demineralization and eventual cavitation.
Let’s take a journey with this case! Patient came to clinic complains pain with cold, food impaction in upper premolar area, feels discomfort with old restoration had 3 years ago! After exploration, taking x rays, complete measures of pain history; how much time response takes to be relived after remove of stimulus? Its better to keep in mind any susceptibility for exposed dentin; Clinically, the depth of caries and residual dentin thickness are difficult to assist.
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