Case 9 - A large carious lesion

In this episode, we explore "Case 9: A large carious lesion" to optimize your preparation for the ADC OSCE exam. Drawing directly from the authoritative source, Odell's Clinical Problem Solving in Dentistry, we dissect the clinical presentation of a 30-year-old patient suffering from severe, short-lasting attacks of pain triggered by hot, cold, and sweet stimuli in a maxillary second molar. We guide you through the cognitive architecture of formulating a differential diagnosis, confirming acute pulpitis and excluding periapical periodontitis based on a lack of pain on biting and positive, hypersensitive vitality testing (such as with ethyl chloride).Listeners will learn how to clinically evaluate radiographic evidence, including assessing the dentine bridge and reactionary (tertiary) dentine formation obliterating the pulp horns. We conduct a technical deep-dive into caries excavation protocols under rubber dam isolation. You will learn how to identify the histological zones of dentine, specifically distinguishing between the superficial, wet, and highly infected dentine that must be removed, and the deeper, dry, "scratchy" affected dentine that can be safely preserved over the pulp to prevent exposure. Finally, we analyze definitive restorative material choices, discussing the biomechanical trade-offs between resin composites, glass ionomer cements, and amalgam for achieving an optimal peripheral seal and promoting remineralization. "This content is purely educational and not a commercial endorsement. For more Dental examination prep tips and clinical deep-dives, please subscribe our Spotify and YouTube channel and share this episode.“ #AcutePulpitis #OdellsDentistry #AustralianDentalCouncil #CariesManagement