Proximal composite restoration from cavity design to polishing

A clinical case by our Community member Dr Mujtaba Qaisar

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.

The proximal cavity is a critical area that requires careful attention. It spans from the gingival seat to the contact area and must be easy to clean to maintain good hygiene. Selecting the right matrix is crucial for achieving proper contact levels, which is essential for optimal results.

styleitaliano style italiano initial situation smile proximal composite restoration technique cavity design polishing proximal walls

Fig.1
Initial Situation: The patient experiences cold sensitivity. Clinical diagnosis reveals that the old restoration has defective margins and some secondary caries. The first step is to isolate the tooth with a rubber dam.

styleitaliano style italiano removal of the old restoration smile proximal composite restoration technique cavity design polishing proximal walls

Fig.2
After removing the old restoration and making cavity design adjustments, it is crucial to achieve proper cavity design for successful proximal restoration. This step is often considered the hidden secret to achieving long-lasting restorations.

styleitaliano style italiano matrix smile proximal composite restoration technique cavity design polishing proximal walls

Fig.3
An equally important step is selecting the right matrix and separation ring, which varies from case to case. This step is crucial to achieving tight and accurate contact levels.

styleitaliano style italiano final situation after polishing smile proximal composite restoration technique cavity design polishing proximal walls

Fig.4
In the final situation, modified simultaneous modeling techniques are used for composite layering, followed by polishing for a final glaze.

styleitaliano style italiano final situation under rubber dam smile proximal composite restoration technique cavity design polishing proximal walls

Fig.5
A side picture shows the contact level of the posterior segment.

styleitaliano style italiano final situation smile proximal composite restoration technique cavity design polishing proximal walls

Fig.6
One month follow-up.

Conclusions

  1. Ensuring the correct height of the proximal walls and achieving a tight contact are essential for healthy and durable restoration in the proximal area.
  2. Composite restoration can be highly effective when managed properly. Pay careful attention to critical details, from cavity design and matrix system selection to polishing, to ensure a long-lasting restoration free from discoloration.

Bibliography

  1. Manauta J, Salat A. Layers An Atlas of Composite Resin Stratification. 2012. Quintessence Pub.
  2. Scolavino, Salvatore, et al. “The Simultaneous Modeling Technique: closing gaps in posteriors.” International Journal of Esthetic Dentistry11.1 (2016).
  3. Restorations, Posterior Direct. “by Salvatore Scolavino, Gaetano Paolone.” Publisher: Quintessence Pub Co(2021).
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