Clinical and Radiographic performances of premixed Bioceramic reparative material in teeth with Acute Reversible Pulpitis – An Interventional Study

Baseline examination -This includes an intra-oral examination using a mouth mirror and probe to check the extent of caries clinically. The dental caries lesion will be identified using International Caries Detection and Assessment System (Code V and VI). The pain intensity will be assessed clinically based on the presence of Tender on Percussion and Visual Analogue Scale (VAS) along with pulp vitality using cold stimulus test where an ice stick will be placed for 3-5sec on the middle third of respected tooth. If the patient gives a positive response for the test, the next step will be assessment of radiographs that will be taken for the respective tooth to assess the carious extent and periapical changes using Orstavick et al (1986) periapical index that will be scored as follows;

1 Normal periapical structures

2 Small changes in the bone structure

3 Change in the bone structure with mineral loss

4 Periodontitis with a well-defined radiolucent area

5 Severe periodontitis with exacerbating features

Method of application of Biodentine:

1.After the baseline examination, disinfection of the cavity will be performed with 2.5% sodium hypochlorite followed by removal of the carious dentin, using spoon excavator Caries removal will be performed first on the margins to avoid pulpal invasion until the infected dentin is removed. The endodontic access cavity under local anesthesia will be made using a high-speed turbine with cooling water. Coronal pulp tissue will be removed using a diamond bur. The pulp chamber will be irrigated with saline solution to remove any pulp traces, and haemostasis will be performed with a gentle application of cotton dry pellet on top and repeated if required up to 6 min; bleeding time will be recorded. After maintaining a dry field for 5-10mins premixed Biodentine cement (Bio c repair) will be placed in the pulp chamber using plastic instruments followed by the placement of posterior glass ionomer cement.

2. After a follow up of 1 week with respect to outcome measures , pain will be reassessed after percussion and cold stimulus. The compatibility of the restoration will also be assessed. The radiographical assessments will be done at the intervals of 3, 6 and 9 months respectively to assess the periapical healing through radiographs using Orstavick et.al Periapical Index (1986) and scores of 3 or more will be considered as non-healing.