Having proper contact in multiple cl II every dentist nightmare

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.

styleitaliano style italiano Initial situation

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.

styleitaliano style italiano isolation

Fig.2
Isolation after the initial cavity preparation showing the presence of caries in tooth 15.

styleitaliano style italiano Cavity design

Fig.3
Complete cleaning and cavity design were achieved on both teeth.

styleitaliano style italiano Matrix and ring placement

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.

styleitaliano style italiano Matrix and ring placement

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.

styleitaliano style italiano Finishing and polishing

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.

styleitaliano style italiano Immediate final result

Fig.7
Immediate final result after checking occlusion and final polishing.

styleitaliano style italiano Checking proximal contact and contour by x-ray

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

  1. Murad Akhundove, Managing multiple contact points, step by step. Styleitaliano.org
  2. Manauta J, Salat A. Layers An Atlas of Composite Resin Stratification. 2012. Quintessence Pub
  3. 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.
  4. 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.
style italiano styleitaliano Essential Dentistry kit online on demand course
style italiano styleitaliano Essential Dentistry kit online on demand course

RELATED CASES

style italiano styleitaliano direct anterior restoration class IV restoration class 4 composite restoration single shade direct restoration

Class IV using just a single shade: dream or reality?

Explore the masterful craftsmanship of Dr. Edoardo Yang Fossati as he creates stunning Class IV anterior composite restorations using only a single shade.