case_images: PMC4731539_01
case_images: A) preoperative intraoral x-ray; B) immediate postoperative x-ray; C) 12-month follow-up; D) 18-month follow-up
case_images: iej-11-75-g001.jpg
case_images: PMC4731539_01_iej-11-75-g001.jpg
case_images: F1
case_images: Radiographic examination revealed a deep carious lesion and complete root-end apical closure, widening of periodontal ligament and presence of a periapical lesion (Figure 1A). After 5 min, the prepared cavity was carefully restored with amalgam and an immediate post-operative radiograph taken (Figure 1B). Intraoral periapical radiographs showed formation of a calcific bridge below the CEM biocement and normal periodontal ligament space width with remineralization of the osseous defect at the 12- and 18-month follow-ups (Figures 1C to D).
case_images: PMC4731539_02
case_images: A) preoperative x-ray; B) immediate postoperative x-ray; C and D) 12-month follow-up bitewing and periapical radiographies
case_images: iej-11-75-g002.jpg
case_images: PMC4731539_02_iej-11-75-g002.jpg
case_images: F2
case_images: Clinically, the mandibular left first molar exhibited an advanced distal carious lesion (Figure 2A) and was sensitive to cold/percussion testing. Hemorrhage was controlled and CEM cement was placed on the exposure site and surrounding dentin with 2 mm thickness; the tooth was restored with amalgam and post-operative radiography was taken (Figure 2B). An important radiographic finding was formation of a hard tissue bridge beneath CEM cement and complete resolution of the apical lesions (Figures 2C to D).