Conservative Endodontic Management of Deep Class II Caries on LR4 in a 67-Year-Old Patient

Patient History & Chief Complaint A 67-year-old male patient presented with spontaneous pain in the lower right posterior region. The patient reported lingering sensitivity to hot and cold stimuli, with pain occasionally radiating to the jaw. Medical history was non-contributory with no systemic contraindications to dental treatment. Clinical & Radiographic Examination Intraoral examination revealed a deep Class II carious lesion on the lower right first premolar (LR4 / tooth 44). The tooth was tender to percussion and exhibited exaggerated, prolonged response to cold testing, consistent with irreversible pulpitis. Periodontal probing depths were within normal limits. Pre-operative periapical radiography confirmed a deep carious lesion approaching the pulp, with no evidence of periapical pathology at this stage. Pre-operative (left) and post-operative (right)…