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Proximal contact tightness for Class II direct composite resin restorations: a literature review Oliver Hinton Dental Update 2024 48:9, 707-709.
Authors
OliverHinton
BDS, MJDF (RCS Eng), MSc
Clinical Dental Tutor, University of Birmingham, General Dental Practitioner, Maple Dental Care Ltd, Sale, Manchester and Abbey Dental Practice, Northwich, Cheshire
This article reviews the literature regarding factors that affect proximal contact tightness (PCT) when restoring Class II cavities with direct composite resin. The PCT between two adjacent teeth is an important factor in maintaining oral health by ensuring that tooth positions remain stable, food is deflected away during mastication, dental papillae are maintained and to facilitate hygienic cleaning. If open contacts are created, there is a greater chance that the patient will experience periodontal problems or caries. Using sectional matrix systems with separation rings, and using materials with less polymerization shrinkage are effective methods to increase PCT and create significantly tighter contacts compared with using circumferential matrix systems.
CPD/Clinical Relevance: Understating the clinical factors that affect proximal contact tightness between adjacent teeth is important to achieve optimal contacts in direct composite resin restorations to maintain oral health.
Article
This article reviews the literature associated with proximal contact tightness (PCT) for Class II direct composite restorations, including in vitro and in vivo studies selected from a search on PubMed, Ovid, Wiley and ScienceDirect (with no date restrictions). It draws out the most clinically relevant results and conclusions, but also highlights any significant limitations and gaps in the current evidence base to summarize those factors that do and do not affect PCT and show which areas require more research.
PCT is dynamic in nature and affected by tooth location and type, patient position, masticatory forces and restorative procedures.1 PCT has even been shown to vary at different times in the day with fatigue of the periodontal ligament and changes in its viscoelastic properties due to circadian rhythms potentially playing a role.1
The correct anatomical form and PCT between two adjacent teeth are important factors in maintaining health by ensuring that forces are redistributed through the long axes of teeth protecting the periodontium, tooth positions remain stable, food is deflected away buccally and lingually during chewing, dental papillae are maintained and to facilitate hygienic cleaning.1 Defective contacts are also irritating for patients who constantly have to remove pieces of food from between their teeth. Open interproximal contacts have not been directly attributed to the loss of alveolar bone, but having a tight contact is still widely accepted to be important in maintaining periodontal health.2
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