case 22: deep and sound caries under the proximal contact

Assalammualaikum Wr Wb.. Good Morning!!

Hi All! fiuuh.. finally i can write down new cases on SekilasKonservasiGigi.Com (A mini series case report update on conservative dentistry from my daily dental practice, it should be updated each week per case, and you can also follow me on my instagram of facebook account by clicking those links. 🙂 )

first of all, i want to greet all muslims who celebrate eid al fitr all over the world, may Allaah SWT bless us always. And thanks to all my family, friends, colleagues, also my patients who supported me until today. 🙂

so, today I want to focus on restorative dentistry cases to be shared. hmm.. for me, premolar is still representing the most common cases where we are not just restoring a tooth, but capable to manage the occlusion and articulation behaviour due to the position of this teeth in the arch.

in the mid of june, i got a patient with a main complaint a sensitive tooth on her upper right tooth in the arch (while she pointed out the tooth with her finger), and it was a premolar. from the occlusal view, there was like a small cavity progressed on this tooth, but when i take a look at the proximal area, hmm.. it would be a biiig cavity.. here is it!

drg. Rio SpKG RK Mayapada gigi 14 kelas 2

Picture Information:

  1. first clinical view from lateral of maxillary right first premolar, showing a big cavity progressed in the distal wall, under the proximal contact. it seemed that this cavity is the caused of the sensitivity that been felt by the patient.
  2. first clinical view from occlusal, showed only a small cavity in the proximal area of upper right first premolar.
  3. caries removal and cavity preparation prior to composite restoration.
  4. matrix placement. look at the gingival wall – matrix junction, it should be as tight as possible, and this can be approached by using appropriate wedge. I used palodent plus (Dentsply) sectional matrix system to restore the tooth with both universal and narrow ring available.
  5. placement of low shrinkage stress flowable composite resin material, SDR (Smart Dentine Replacement – Dentsply) to get the restoration with a predictable and achievable result over the gingival wall. Followed with universal packable microhybrid composite material, z250 (3M ESPE).
  6. finished restoration right before the finishing and polishing procedure. Take a look at the blood in the sulcus, this happened due to the removal of wedge which may rupturing the blood vessels.
  7. finished restoration of upper right first premolar. the polishers i used were white stone/arkansas, enhance (dentsply), and Soflex (3M ESPE).

Yup, that’s for my 22nd story in SekilasKonservasiGigi.Com, For more stories please visit CeritaPasienRio.Com or browse my fb at and don’t forget to click the follow botton on your rigth side to get the latest updates from my site.. see you on my next dental story.. thank You Very Much, keep UP the GOOD WORK!! keep on Sharing, with love from Jakarta, Indonesia

Wassalammualaikum Wr Wb..

-drg. Rio Suryantoro, Sp.KG-

M e e t   m e   a t :

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About Rio Suryantoro, drg., Sp.KG

Dentist, conservative dentistry specialist (Restorative Dentisty and Endodontist)|case reports' author on and|trainer of conservative dentistry | live in Jakarta.
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