Class II Composite restoration with added tips and tricks !!

Performed by:

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.


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