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Deep carious lesions

• Primary vs permanent teeth

• Mature vs immature permanent teeth

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• Local anaesthetic
• Good isolation with rubber dam

• Removal of caries

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• Complete removal of roof of pulp chamber

preferably with a non-end cutting bur
• Removal of coronal pulpal tissue with sharp
sterile excavator (recommended) or large
round bur in a slow speed handpiece

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• Attain initial radicular pulpal haemostasis by

gentle application of sterile cotton pledget
moistened with saline (haemostasis should be
achieved within four minutes)

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Medicament for direct application to radicular pulp

stumps to include any of the following:
– 15.5% ferric sulphate solution burnished on pulp
stumps with microbrush for 15 seconds to achieve
haemostasis, followed by thorough rinsing and drying
– 20% (1:5 dilution) Buckley’s formocresol solution
applied to radicular pulp on a cotton pledget for five
minutes to achieve superficial tissue fixation
– MTA paste applied over radicular pulp with
proprietary carrier

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• Fill the chamber with zinc oxide eugenol

cement, pressing on the zinc oxide with a
damp pledget to make sure that it is well
condensed in the chamber

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• https://youtu.be/CevdtCMd-tE

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• Place coronal restoration, preferably a

stainless steel crown.

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