Rebuilding the anatomy in class II cavity restoration is a major issue in posterior aesthetics and, most of all, function; this, especially if you don’t want to make too many occlusal adjustments after finishing the layering procedures. It is therefore of paramount importance to rebuild a tooth with a correct morphology and anatomy. Respecting the correct proportions of the occlusal pattern with correct cusps, grooves, ridges and pits, few adjustments are needed to get a proper occlusion.
Fig.1
M.R., 22 years old came to our observation for increased thermal sensitivity in zone 36-37. The RX examination shows an occlusal caries on tooth 37 and a large decay distal 36
Fig.2
The rubber dam was put in order to have optimal control of the operating field.
Fig.3
During the main operations for the removal of the caries was the distal wall was deliberately left so as not to damage tooth 37.
Fig.4
Particular attention was paid to the correct positioning of the matrix with the aim of making it better adhere to the tooth.
Fig.5
Instead of rebuilding the distal wall of the tooth by transforming the II class to a class I cavity, it was preferred to proceed with small composite increments in order to reduce the polymerization contraction and to perform an anatomically guided reconstruction.
Fig.6
Two composite masses were used, first the body dentin and then the enamel.
Fig.7
We can see the occlusal control with well-distributed contact points.
Fig.8
As you can see in this picture, even after the occlusal adjustments the anatomy remained almost unchanged.
Conclusions
When a tooth has been rebuilt according to an anatomically guided pattern, very few occlusal adjustments are required, the relationship between enamel and dentine body is not altered with unaesthetic dentine exposure, contact points are better distributed with consequent reduction of occlusal stress and a better occlusal stability.
