Large failing amalgam restorations on teeth numbers 4 and 5, exhibiting marginal leakage and recurrent decay.
Buccal view of teeth numbers 4 and 5, pretreatment, showing signifi cant discoloration.
Removal of MODB amalgam #4 and excavation.
Tooth #4 was restored using Composi-Tight 3D rings. I employed a self-etching bonding agent (Clearfil SE Protect, Kuraray) followed by a bulk-filling composite (SureFil SDR, Caulk Dentsply) and then a surface layer of microhybrid composite (Majesty Esthetic, Kuraray). Crude anatomy has been created. Next, I prepared to fill #5. A more certain marginal seal to enamel can be obtained by selectively etching enamel margins with phosphoric acid as shown.
Set-up of Composi-Tight matrices, wedges and rings. The original 3D ring works fine on the distal, where clinical crown height is adequate. With shorter teeth, or distals of cuspids, the 3DXR ring is ideal because the tines on the blue pad “hook” under wedge, securing it in place and preventing ring pop off.
Crude buildup of #5, also using Clearfil SE Protect, SureFil SDR, and Majesty Esthetic.
Fully restored teeth numbers 4 and 5. Due to size of restorations, the patient was alerted that both teeth may be candidates for full coverage in the future when the patient is more financially able.
Buccal view of teeth numbers 4 and 5 after restoration.