Replacing Class II with Recurrent Caries

Dr. Giulio Pavolucci

Private Practice

Montepulciano ITALY

Visiting professor at Siena University

Case Details

DATE OF ISSUE

November 2023

This case report is published as an inspiration for you as a clinician and not necessarily as a recommendation from Dentsply Sirona

Patient Details

AGE

36 years old

GENDER

Female

Mesial Occlusal Restoration to Replace a Class I with Recurrent Caries

Initial situation of the patient

The patient noticed a brown spot on a molar, so she came for a control visit. No symptoms were referred.

Before

Initial situation: a decayed groove on the occlusal surface of 4.7. The x-ray shows a distal radiotranslucency on 4.6.

After

Final situation 3 weeks after the ﬁllings. Great comfort and no sensitivity at all were reported by the patient.

Diagnosis

Clinically, a small carious lesion is visible on occlusal surface of 4.7.
On the x-ray examination, a distal translucency was found on tooth 4.6.
Marginal inﬂammation and plaque were present.
No symptoms were referred by the patient.

Treatment Plan

Isolation
Caries removal
Matrix placement
Adhesion
Centripetal build-up technique
Bulk restoration with SDR® flow+ material
Occlusal layer with Spectra ST¹ Composite

Clinical Workflow

Step 1:

The situation after rubber dam isolation.

Step 2:

Initial cavity preparation, protecting the adjacent tooth with a Palodent1 WedgeGuard.

Step 3:

Class II cavity prepared.

Step 4:

The complete Palodent1 system in place: sectional matrix, wedge and ring.

Step 5:

Adhesive application with a universal adhesive, Prime&Bond².

Step 6:

Effective and fast light curing process with SmartLite® Pro Curing Light, after application of Prime&Bond².

Step 7:

A ﬁrst thin amount (0.5 mm) of SDR® ﬂow+ material is used as a low stress “adhesive protection layer”.

Step 8:

Transformation of class II into class I, restoring the interproximal wall with Spectra ST3 composite in shade A2.

Step 9:

Transformation of a big class I into a small class I, using SDR® flow+ material in one increment up to 4 mm.

Step 10:

Occlusal surface restored using Spectra ST³ composite in shade A2.

Step 11:

Occlusal check.

Step 12:

Finishing with Enhance® Finishers.

Step 13:

3 weeks control.

_{1 Depending on market location, Palodent Matrix Systems are available Palodent® Plus or Palodent® V3

2 Depending on market location, Prime&Bond adhesives are available as either Prime&Bond elect®, Prime&Bond active®, or Prime&Bond Universal™

3 Depending on market location, Spectra ST composites are available as either TPH Spectra® ST, Ceram.x Spectra® ST, or Neo Spectra® ST}