A clinical case by our Community member Dr. Muhammad Alhafudh
This article and its content are published under the Author’s responsibility as an expression of the Author’s own ideas and practice. Styleitaliano denies any responsibility about the visual and written content of this work.
This patient came to the clinic complaining of food impaction between teeth 45 and 46, both of which presented carious infiltration.
Fig.1
The proximal area was opened before isolation in order to avoid rubber dam lacerations. A wedge was used to protect the papilla.
Fig.2
After isolation, it was possible to proceed to cavity cleaning.
Fig.3
Decayed tissue was removed. Enamel was finished with fine burs to prevent the detachment of unsupported enamel prisms and micro-leakage.
Fig.4
Matrices were placed and secured with a wedge.
Fig.5
To allow the matrix to embrace the tooth, we used a special NiTi ring, which presses the matrix onto the proximal wall, and creates forces that enhance separation between walls to create an optimum seal during proximal modeling and a tight contact point.
Fig.6
After enamel etching, the cavities were dried.
Fig.7
Bonding was brushed into the cavity of 46 and air-blown to remove excess and make the solvent evaporate. The cavity of tooth 45 was protected with teflon tape to support the matrix and avoid contamination.
Fig.8
The mesial wall of 46 was layered by Enamel shade from the Professional CompoSite System (White Dental Beauty), which is easy to model and has very good optical properties.
Fig.9
Before removing the sectional matrix, the dentin was sealed with flowable composite (0.5 – 1 mm).
Fig.10
The distal wall of tooth 45 was built. Before layering the occlusal surface, the outline of the restoration was finished with discs.
Fig.11
After layering the occlusal anatomy, the restorations were polished by using the Lucida Star felt and sub-micron, hybrid and water-soluble paste.
Fig.12
The finished and polished restorations.
Fig.13
Immediately after rubber dam removal and bite check.
Conclusions
The reconstruction of the original anatomical structures is a very important, as every groove, fossa and ridge have their role in functional contacts and movements. So when a tooth is restored according to an anatomically guided pattern, very few occlusal adjustments are required.
Bibliography
1. Manauta J, Salat A. Layers An Atlas of Composite Resin Stratification. 2012. Quintessence Pub.
2. Dias W. New techniques and tools for approximal restorations of class II. Walter Dias. DentArt Magazine 2012 No66.
3. Chiodera G. Simplify class 2 restoration. 2020. Styleitaliano.org.
