Fig. 1

A 24-year-old adult patient presented to the clinic for general control.

The patient has no complaints or symptoms

Preoperative x-rays showed the presence of deep caries in the maxillary first molars and second premolars.

Cold test positive

Negative percussion

Fig. 2

The dark reflection of the caries at the proximal of the tooth iwas seen.

Rubber dam isolation of posterior segment

Fig. 3

Cavity preparation started from the occlusal surface

Fig. 4

It was observed that the caries progressed towards the proximal contact point of the tooth.

Fig. 5

As the caries of the molar tooth was removed, it was observed that there was caries on the distal wall of the premolar tooth. At the same time, caries of premolar tooth was also removed.

Fig. 6

All caries of molar and premolar teeth were removed 

Fig. 7

After removing caries, exposed pulp on molar tooth was seen.

Bleeding control was achieved with sodium hypochlorite after pulp exposure.

Fig. 8

Direct pulp capping with Mineral Trioxide Aggregate (MTA) on molar tooth 

Fig. 9

Application of dentin liner over MTA 

Placement of sectional matrix system

Fig. 10

Composite restoration of the premolar distal wall

Fig. 11

Composite restoration of the molar mesial wall

Fig. 12

Composite restoration of molar and premolar tooth from occlusal aspect

Fig. 13

Finishing and periapical control film

Fig. 14

Occlusion control from buccal aspect

Fig. 15

The 6 years follow-up and control with X-ray

The patient presents with no complaints, symptoms and pathological changes. 

Fig. 16

X-rays taken during the pre-operative, post-operative, and 6-year follow-up periods.


Direct pulp capping procedures offer the advantage of minimal invasiveness in cases of pulp exposure in permanent dentition. The usage of a MTA material that is biocompatible, bioactive, and possesses sealing capabilities in such contexts has the potential to significantly improved the long-term success.


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