08 Feb Class II Composite restoration with added tips and tricks !!
Performed by:
Dr. Ahmed Khairy
Abstract:
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 !!!
Conclusion:
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.
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