From: Rafaël Michiels
To: ROOTS
Sent: Friday, November 20, 2009 4:23 AM
Subject: [roots] Direct Capping with MTA
here is a case I finished today.

The patiënt was referred for endo of the 4.7
Tooth responded normal to sensibility testing, there were no spontaneous symptoms and the patiënt
was only 29 years old.

I removed the caries and exposed a little pulp horn. While removing the caries I constantly rinsed
with CHX 0,2% aequous solution. When I finally had all the caries removed  hemostasis was achieved
with a cotton pellet soaked in CHX 0,2% aequous solution and was left in the cavity for 5 minutes,
I had a coffee then.

After this I placed MTA angelus and let it set. On the MTA I placed a temporary filling in Fuji IX,
which will be left in place for about 6 months. Further follow-up will happen in:

1 week (telephone)
1 month (telephone)
3 months (office)
6 months (telephone)
1 year (office)

Now, fingers crossed and hopefully he does not phone me tomorrow with an acute pulpitis :-) - Rafaël




Hello Dr. Michiels, do you removed the pulptissue of the pulphorn?
I don´t know the literature. Is there any reason (and I expect there is
one) why you use CHX 0.2% solution for cavity cleaning and hemostasis?
-  Leo Zutz

Hello Leo,
I did remove the pulp tissue of the pulphorn with a new round bur, so, not the one I used to remove
the caries. The reason for the use of CHX 0.2% is because of its antimicrobial capacity, but you can
also use CHX gel 1% or 2%. In the literature, a lot of different concentrations are used - Rafaël


thanks for the reply and comments! I had a similiar case one year ago.
No problems up to this time...hope it will be long lasting! - Leo