A clinical case by our Community member Dr Meena Isam
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.
Having proper contact in multiple cl II restorations was considered a nightmare for clinicians. The most challenging in these cases is to restore proper, healthy, and functional contacts to prevent future food stagnation. Accordingly, the aim of this case is to simplify the procedure of restoring multiple proximal cavities.
Fig.1
Initial situation, a male patient presented to the clinic with multiple proximal caries. The initial photograph demonstrated that the patient is suffering from cavitation and food impaction between teeth 14 and 15.
Fig.2
Isolation after the initial cavity preparation showing the presence of caries in tooth 15.
Fig.3
Complete cleaning and cavity design were achieved on both teeth.
Fig.4
For tooth 15, a transparent sectional matrix was used for the distal wall to restore a correct proximal contour without distortion. In addition, placing a ring was considered important for ensuring an intimate adaptation of the matrix with the tooth surface and to gain more separation. For mesial proximal wall, a metal sectional matrix was secured by a wedge.
Fig.5
After finishing the restoration for the tooth 15, the restoration of the tooth 14 was started by placing a sectional matrix secured with a wedge. To restore a proper proximal contour, placing a ring for separation and adaptation of the band on the tooth surface were considered the key of the treatment plan.
Fig.6
After completing the restoration for the tooth 14, the finishing and polishing procedure is achieved.
The proper proximal contour for both premolars can be clearly seen.
Fig.7
Immediate final result after checking occlusion and final polishing.
Fig.8
Checking proximal contact and contour by x-ray.
Conclusions
Restoring multiple proximal cavities can be challenging. To simplify the working flow and to get the ideal results, a good diagnosis and a preoperative treatment plan are crucial.
Bibliography
- Murad Akhundove, Managing multiple contact points, step by step. Styleitaliano.org
- Manauta J, Salat A. Layers An Atlas of Composite Resin Stratification. 2012. Quintessence Pub
- Wirsching, E., Loomans, B. A. C., Klaiber, B., & Dörfer, C. E. Influence of matrix systems on proximal contact tightness of 2- and 3-surface posterior composite restorations in vivo. Journal of Dentistry,(2011), 39(5), 386–390.
- Hardan L, Sidawi L, Akhundov M, Bourgi R, Ghaleb M, Dabbagh S, Sokolowski K, Cuevas-Suárez CE, Lukomska-Szymanska M. One-year clinical performance of the fast-Modelling bulk technique and composite-up layering technique in class I cavities. Polymers. 2021 Jun 4;13(11):1873.
