Our patient presents with a small fracture on this upper left second bicuspid tooth. Clinical exam shows an a-symptomatic tooth (doesn’t hurt). The radiograph, however, shows a large radiolucency (dark area indicative of hard tooth structure resorption) that is near the nerve.

Local anesthesia was administered (topical plus Carbocaine 3%) prior to careful excavation (utilizing high powered magnification).

Though the decay was deep, the nerve was not exposed. Calcium hydroxide (Dycal) was utilized as a base prior to placement of a bonded composite restoration. Utilizing conservative operative techniques, the tooth was restored avoiding the time and expense of a crown restoration.