Case of the day 5/11/2020

Chief Complaint: Patient presented with interproximal caries.

Clinical challenges:

Not enough mechanical retention: The previous dentist performed a conservative slot preparation. Inadequate mechanical retention caused failure of the previous resin restoration.
Unable to seat the matrix band due to wire and bracket: Patient had braces and could not see his orthodontist for another 2 months due to COVID 19.

Clinical treatment:

Used #245 pear shaped to achieve buccal and lingual mechanical retention. Extended the pupal axial wall for bulk filled. Extended to the mesial pit for added resistance.
Used a small matrix band and cut into size. Wedged buccal and lingual for anatomy. Checked with mirror and removed all blood in the slot.
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)
Contact and occlusion adjusted with round bur.

Self-evaluation: Marginal ridge and contact were restored. Mesial pit was sealed.

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