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Restoring The Interproximal Complex PDF

This document describes restoring the interproximal contact area using direct composite restorations. It discusses the anatomy and function of the contact area, including the embrasure, proximal contour, and marginal ridge. Improperly restored contacts can lead to food impaction and periodontal disease. The case reports demonstrate restoring contacts using pre-contoured matrices and wedges to achieve the correct physiology form and tight contact. Restoring proper contacts improves self-cleansing, tissue health, and hygiene.

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187 views33 pages

Restoring The Interproximal Complex PDF

This document describes restoring the interproximal contact area using direct composite restorations. It discusses the anatomy and function of the contact area, including the embrasure, proximal contour, and marginal ridge. Improperly restored contacts can lead to food impaction and periodontal disease. The case reports demonstrate restoring contacts using pre-contoured matrices and wedges to achieve the correct physiology form and tight contact. Restoring proper contacts improves self-cleansing, tissue health, and hygiene.

Uploaded by

adit
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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A case report

RESTORING THE INTERPROXIMAL


CONTACT
ADITYO W (PERIO RESIDENT UNIV.INDONESIA)
Contact area (sturdevant 2006)

 Area of proximal height of contour of the


proximal surface that touches its adjacent
tooth in the same arch
 keep food from packing between tooth
 Proximal contact and interdigitation maintain
the integrity of the dental arch
Interdental col (sturdevant 2006, Carranza
2002)
 A central faciolingual concave area beneath the
contact
 Vulnerable to periodontal disease from incorrect
contact and embrasure form because it covered
by non keratinized epithelium
Interproximal contact
physiological form (sturdevant 2006,
wheeler 2003)

1. Contact area
2. Embrasure
3. Proximal contour
4. Marginal ridge
5. Interdental col
Function

 Self cleansing
 Tissue stimulation
 Tissue protection
 Arch integrity
Contact area location
The upper middle third of the crown of most teeth,
providing natural embrasures and an opportunity
for good maintenance of the interproximal area.
Embrasure
 Function
 Spillway for food during mastication
 Prevent food from being forced
through the contact area
 V-shaped spaces widen out from
proximal contact area between
adjacent teeth
 Facial
 Lingual
 Oclusal
 Gingival ---filled with papilla to
prevent debris retention
Proximal contour
 the posterior proximal
surface is convex occlusally
and concave gingivally
 a concavity exists that
houses the interdental
papilla
 Adequate embrasure space
for gingiva, supporting bone
and supracrestal fibers
Marginal ridges
 Rounded border of the enamel
which forms the distal and
mesial margin of the occlusal
surface
 Provide spillway during
mastication
 Helps balancing of teeth in
both arches
 If the marginal ridges not at
the same height, proper
contact and embrasure form
wont be achieved
Interproximal contact disturbances

 Proximal contact loss or not


tight enough
 Proximal caries
 Overhanging restoration
 Under/over contour
restoration
 Tooth malposition
 Irregular marginal ridges
Food impaction (Kim,2000)

 The forceful wedging of food into the


periodontium
 Common areas of food impaction :
 Vertical impaction :
 Open contacts
 Irregular marginal ridge
 Horizontal ( lateral ) food impaction : enlarged
gingival embrasure
 Plunger cusps : cusps that tend to forcibly
wedge food interproximally
 Restore interproximal contact to avoid food
impaction and allow hygine access

 Means,

 Restore the physiological form of the


interproximal component
1. Embrasure
2. Proximal contour
3. Marginal ridge
4. Contact area and
5. contact tightness (Lowe , 2008)
Clinical consideration in
interproximal restoration
 Pulp status
 Caries extension
 Periodontal condition
 Cavity margin location
 Tooth position to the adjacent tooth

 Direct restoration
 Indirect restoration
 Preliminary treatment
Direct composite restoration to
restore proximal contact area
 Composite and bonding system
 Matrix system
 Circumferential
 Sectional
Case 1
 28 y.o. female
 Chief complaint : discomfort, pain and
bleeding gum in the lower left area, retained
food debris even after flossing and
mouthwash
 OHI-S : 0,97
 Tooth 3.5, 4mm perio pocket in mesial and
distal, overhang composite restoration, easily
bleeding gingiva, redness, edema, food
debris beneath the overhang restoration
Pre-op and preparation
Weapon of choice
Immediate post-op and after
polishing
1 month post-op
•No complaints
•Effortless maintenance
•2mm sulcus depth
•Absence of edema ,
redness and bleeding on
probing
Upper right dentition from the same
patient
Preparation and after
restoration
1 month post-op
Case 2

 40 y.o female

 With food impaction e.c. Proximal caries


between 24 and 35

 Discomfort when food debri retained


between tooth

 Loss of several teeth in the maxila


Courtesy of J.Patrick dds,
Discussion
 Precontoured matrices
 Convex proximal contour
 Marginal ridge support
 Physiologic contour for optimum soft tissue
response
 Anatomical wedges
Optimum
gingival
adaptation of the
matrices
 Separating retention ring
 providing slight separation of
the contacting teeth
 Matrices adaptation for
optimum embrasure form
 Compensating matrices
thickness
 The wedge is to only provide
optimum gingival adaptation
of the matrices
 Management of moisture, bleeding in the
interproximal tissue

 Hemostatic scrubbing
 Hemostatic paste
 Retracting cord
Conclusion

 Properly contoured restoration in the


interproximal area will provide
 Self cleansing
 Promote soft tissue health and stimulation
 Avoid food impaction and further periodontal problem
 Ease hygine access

 Sectional matrices system provide slight


separation of the contacting teeth and reproduce
adequate tightness with adjacent tooth
 When restoring the proximal contact of the
posterior area with direct restoration,
moisture control and soft tissue management
are crucial

Fin…….
FIN……
THANK YOU

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