Proximal Caries in posterior and anterior teeth.pdf

Proximal caries in posterior and anterior teeth  Clinical Case HK Yoo; SH Kim; SI Kim; YS Shin; SJ Shin; JW Park Seven-year Follow-up of Resin Infiltration Treatment on Noncavitated Proximal Caries Oper Dent (2019) 44 (1): 8–12. From: Seven-year Follow-up of Resin Infiltration Treatment on Nonca...

Proximal caries in posterior and anterior teeth  Clinical Case HK Yoo; SH Kim; SI Kim; YS Shin; SJ Shin; JW Park Seven-year Follow-up of Resin Infiltration Treatment on Noncavitated Proximal Caries Oper Dent (2019) 44 (1): 8–12. From: Seven-year Follow-up of Resin Infiltration Treatment on Noncavitated Proximal Caries Oper Dent. 2019;44(1):8-12. doi:10.2341/17-323-L Tunnel Preparation Tunnel preparation Slot Preparation Slot preparation, also known as mini box preparation, is designed mainly for proximal caries. It can be divided into the following cases: 1. Caries is close to the marginal ridge and cannot preserve its integrity or the marginal ridge has been destroyed. 2. Caries is located underneath the interproximal contact. Designing of cavity preparation focuses on carious tissue; if the marginal ridge cannot be preserved, the cavity is only prepared into a box shape without a dovetail Slot preparation When the caries is underneath the interproximal contact, carious tissue is approached from the buccal or lingual surface, and prepared into a box or disk shape with the auxiliary help of groove retention.  Slot Cavity Microscopic Preparation Class II Cavity Class II Cavity Class II cavity Class II Cavity Class II Cavity Class II Cavity Enter the tooth through the occlusal surface using a small rotatory instrument to find the caries. A number 2 carbide round bur will be suitable, depending on the size of the cavity. Maintain a small external outline while attempting to remove the occlusal and proximal caries. The size of the external outline needs to be appropriate to allow for visualization of the caries. No specific shape or outline is necessary, but the external outline needs to be on sound enamel or dentin. Decalcified enamel must be removed, as well as any old restorative material, which will expand the size of the external outline Cavity II Caries Expand internally for initial removal of gross caries. Apply a caries finder for 10 seconds, and rinse. Remove caries until all infected dentin has been removed. Cavity II Caries When breaking the proximal wall it is desirable to use a wedge guard or a metal matrix to protect the adjacent tooth. The external fluoride-rich layer should be protected to avoid the increased possibility of caries. Full interproximal clearance, which is needed for GV Black-influenced design of cavities, is not mandatory Class II Cavity A lack of proximal clearance may make it difficult to insert a matrix band. A margin separation technique can simplify matrix band insertion and will also work for minor interproximal beveling. Using a wedge guard will protect the adjacent tooth. Placing a wedge to separate the tooth and a matrix band may be all that is necessary. Another possibility is to pre-separate the teeth by placing a ring in advance of the cavity preparation. Class II Cavity When caries approaches the gingival margin, the supragingival protocol should be employed. Minimally invasive removal of caries and old restorations and enamel preservation techniques will make restoring easier, more predictable and healthier for the periodontium Class II Cavity Remove the sharp external cavosurface margin throughout, to remove loose enamel rods and enhance adhesion using a flame diamond Class II Cavity Essential burs. ▪ Very small-diameter flame bur (FG; 006– 008): used for conservative opening of suspect grooves. ▪ Cylindric bur with rounded head (FG; 007– 0014): used for most Class 1 and 2 cavity preparations. ▪ Tungsten carbide rosehead bur (CA; 010– 020): used to remove infected dentin. ▪ Fine-grained flame bur (FG; 010): used to finish Class 2 box walls. ▪ Arkansas stone (FG): used to smooth the cavity margin. ▪ Brownie polisher (CA): used to polish the cavity margin. Restoration of Proximal caries Restore the proximal wall Matrix Tofflemire Sectional Matrix Applying Palodent https://youtu.be/ZyopvlYQORE Omni-Matrix Transaparent matrix Auto-Matrix https://youtu.be/wPznsWGwdgA Palodent 360 https://youtu.be/e66e87gBEE4 Wedges Wedges Wedge insertion Wedges Wedges Wedges Wooden wedges Wood Wedges Wood Wedges Modifying Plastic Wedges Expansion wedge Expansion Wedges Composite restoration Manauta custom rings Manauta Custom Ring Manauta custom ring Proximal Caries Anterior Teeth  General Steps (5) if the restoration (2) occlusal (1) Anaesthesia is (3) the composite involves the proximal assessments should be usually necessary for shade must be selected contact, inserting a made to determine the (4) the area must be patient comfort and before the tooth wedge in the area tooth preparation isolated to permit helps decrease salivary dehydrates and beforehand may assist design and to properly effective bonding; flow during the concomitantly in the re-establishment adjust the restoration’s procedure; lightens; of the proximal contact function; with composite. Class III Class III Class III preparation Class III Class III Class III The preparation is initiated from a lingual approach (if possible) by using a round bur instrument of a size compatible with the extent of the lesion. Before contacting the tooth, the bur is positioned for entry and rotated at high speed using air-water spray. The point of entry is located within the incisogingival dimension of the lesion or defect and as close to the adjacent tooth as possible without contacting it. The cutting instrument is directed perpendicular to the enamel. Incorrect entry overextends the lingual outline and unnecessarily weakens the tooth. Class III Class III Bevel Class III Class III Class III Class III Class III Class III Class III Class III Class III Class III Class III Class III Place composite into the most facial portion of the preparation, beginning at the facial-axial line angle Increments of composite should be no more than 2mm thick Class III Using the index finger, hold down on the facial portion of the mylar strip and wrap the lingual portion over the lingual contour of the tooth to create the proximal anatomy Class III Remove gross excess material or overhang as needed Use the more abrasive side of the finishing strip to reduce interproximal excess Insert the finishing strip by the grit-free middle portion and move it buccally and lingually to contour and smooth Do not use the finishing strip in the contact area Use a No. 12 surgical blade or scaler to remove interproximal excess material in the gingival area Shave from the tooth onto the restoration using light strokes. Always maintain portion of the blade on enamel as a contour guide Class III Class III https://digitalmedia.sheffield.ac.uk/media/Class+III+Cavity+Pr eparation+and+Restoration/1_at9da395/80777771