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Direct cusp covering of vital element with very deep cervical margin

Dr. Daniele Gensini

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Case Details

The case presents the need to seal the cervical margin which is in a very deep position, even if it can be isolated with a dam, and to recreate an adequate emergence profile. Thanks to the particular design of the Slick Band matrices, this step was easy and made it possible to bring the restorative margin into a favorable position. Subsequently, after having recreated the direct covering of the missing cusp, thanks to a previously created silicone index, the missing proximal wall was reconstructed thanks to the aid of a 3D Fusion anatomical matrix, very useful for obtaining a correct emergence profile and an appropriate proximal contact point. Finally, the modeling of the restoration was completed and the correct occlusal contacts were checked

Figure 1: Clean cavity with deep cervical margin
Figure 2: Occlusal view. Vital element
Figure 3: Slick Band matrix placement with correct emergence profile
Figure 4: Precise adaptation of the matrix to the margin
Figure 5: Selective enamel etching
Figure 6: Universal adhesive
Figure 7: Highly filled flowable composite for reconstruction of the deep cervical margin
Figure 8: Margin sealed and dentin covered with flowable composite
Figure 9: Restorative margin in a favorable position and with correct profile
Figure 10: Silicone index to reconstruct the missing cusp
Figure 11: Reconstructed stamp cusp
Figure 12: Correct adaptation of 3D fusion matrix to the new restorative margin
Figure 13: Placement of composite resin for the proximal wall
Figure 14: Proximal wall just reconstructed
Figure 15: Completion of the modeling of the occlusal table
Figure 16: Characterized, finished and polished restoration
Figure 17: Lateral view of the correct emergence profile recreated
Figure 18: Just removed the rubber dam
Figure 19: Occlusal check

About the Author

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Dr. Daniele Gensini

Dr. Daniele Gensini graduated with honors in Dentistry at the University of Siena in 2004, where for three years he worked as a tutor for students in the Prosthetics department, directed by Prof. Andrea Borracchini. He then trained in Italy and abroad in prosthetics, periodontology, implantology, dental aesthetics and gnathology, including the annual master’s degree of Dr. Mauro Fradeani, the two 2-year master’s degrees of Dr. Roberto Pontoriero, the annual courses of Dr. Stefano Gori and the annual course of Dr. Mario Molina. Dr. Gensini dedicates his clinical activity to prosthetics on natural teeth and implants, implantology, periodontology and dental aesthetics with direct and indirect techniques in his private practice in Rome. He also teaches courses and conferences in universities and private institutions both in Italy and abroad in English. He’s an active member of the Italian Society of Conservative Dentistry. Since 2018, Dr. Gensini has been a member of the Fradeani Education team as a speaker and tutor in various courses around the world.