In MID, what strategies help preserve pulp vitality in deep lesions?

• A. Selective caries removal with liner, indirect pulp capping, use of biocompatible capping materials, and minimal heat generation
• B. Complete caries removal with deep cavity prep followed by immediate amalgam filling
• C. Aggressive heat generation with full pulp exposure and direct pulp capping with calcium hydroxide
• D. Delaying treatment until symptoms arise

Answer: (D)

In minimally invasive dentistry, preserving pulp vitality in deep lesions relies on managing caries in a way that protects the pulp while still removing decay. The best approach combines removing only the infected caries while leaving affected dentin to maintain structural support and biological healing potential, using a liner or indirect pulp cap to protect the pulp, and applying biocompatible capping materials when the pulp is near exposure or slightly exposed. This promotes dentin bridge formation and a durable seal, while minimizing irritation to the pulp. Coupled with minimal heat generation during preparation and a well-sealed restoration to prevent microleakage, these steps help keep the pulp alive and functional.

Complete removal with deep prep and immediate amalgam, or aggressive heat with full pulp exposure, would raise the risk of pulp injury and posttreatment problems. Delaying treatment until symptoms appear allows ongoing decay and potential pulp involvement, which undermines vitality preservation.