08 Feb Class II Composite restoration with added tips and tricks !!
Dr. Ahmed Khairy
Restoring Class II is not just about restoring contacts, but also about restoring contour and profile of the tooth. Showing a case with back to back class II cavitation in a patient having gingival recession. exposing concavities at the cervical tooth surface and causing (Black triangles).
what I did was over-molding cervical margins depending on the self adaptation of celluloid matrices to create a new emergence profile. delayed wedging was done so I can benefit from the matrix profile.
Description under each photo.
#1 Pre-operative scenario showing cracks at the marginal ridges which highly indicate the presence of interproximal decay.
#2 Pre-operative radiograph
#3 Pre-wedging before rubber dam placement
#4 initial cavity preparation.
#5 completed cavity prep ( with partial caries removal on upper 5)
#6 Cleaning cervical margins from calculus and plaque using ultrasonic scaler, air abrasion and metal strips to make sure this part is a good substrate for adhesion
#7 here you can see the concavity on both proximal margins.
that is why planning for overmolding and delaying wedge placement to change the proximal profile
#8 you can see the change between the profile of the matrix and profile of the proximal wall
#9 the first step was overmolding both cervical margins with only flowable composite.
#10 showing the new profile
#11 occlusal view of the overmolded proximal surfaces.
#12 now placing the wedge, and building the proximal wall of the 2nd premolar
#13 removing the matrix of the builded wall and placing ring for tighter contact
#14 building the second proximal wall
#15 combining function with esthetics though creating anatomy and some stains.
#16 occlusal view of finishing and polishing of both restorations
#17 palatal view showing emmergence profile and papilla fill
#18 papilla filled the gap just 2 days after placing the restoration due to proper creating of emergence profile
#19 Post operative radiograph showing overmolding of cervical margins with no overhangs !!!
Class II Composite restorations require careful planning and execution in order to provide a restoration with proper contact area location, tightness and with respect to emergence profile.