Case of the day 5/12/2020

Chief Complaint: Patient presented with abfraction on #5.

Clinical challenges:

• Subgingival gingival floor

• Minor food trap because of wide facial embrasure between #5 and 6.

Clinical treatment:

• Used #245 pear shaped to create groove on the occlusal-pulpal line angle. The bur was tilted mesial and distally to create enough retention for the resin material.

  • Used coarse diamond crown bur to create a lot of bevel on the tooth (shaded yellow area)

• Packed #1 cord impregnated in hemodent before access the gingival floor to avoid as much bleeding as possible.

  • In this case, hemostasis was achieved from the first cord. If hemostasis cannot be achieved, wait 10 minutes, removed #1 cord, packed #00 cord and #0 cord.

• Used plow-sow technique to fill the box: Applied flowable composite, DO NOT CURE, applied packable composite. Used composite instrument to create anatomy. CURED. Air dried and applied another layer of flowable composite (like sealants)

• Polished with white stone and slow speed brush for more shiny appearance. At the

Self-evaluation:

• Anatomy was restored and enhanced. Narrower or thinner embrasure between #5 and #6.

• The tooth looked whiter becauase of being air dried or lighter composite shade. I think it is better to use A3 instead of A2 in this case.