Article: Volume 46 Number 5 Page 438 - May 2019

  Dent Update 2019; 46: 438-449  Read article

Restorative dentistry:  Managing ‘Last Tooth in the Arch Syndrome’ and Restoring Retruded Contact Position

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Abstract: Occlusally challenging scenarios can arise during the restoration of teeth involved in the patient’s Retruded Contact Position (RCP). During preparation of a tooth that provides the RCP, practitioners may encounter problems whereby they lose occlusal clearance to place an occlusal coverage restoration over the tooth in question. This may come as a shock to the practitioner, often resulting in further excessive and unplanned tooth preparation, or reduction of the opposing tooth to create occlusal clearance. This paper aims to provide a guide on how to recognize and avoid the potential pitfalls of restoring retruded contact position, through the use of proper planning and by employing appropriate management techniques.

Clinical relevance: Understanding of the relevant occlusal considerations will allow the practitioner to restore teeth involved with RCP predictably and conservatively.

Author notes: Kameran Ali, BDS(Hons), (email: and Thomas Addison, BDS, MSc, FFGDP RCS, DPDS, PgCertAP, FHEA, Senior Clinical Tutor in Restorative Dentistry, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK.

Objective: To demonstrate appropriate planning and management techniques when restoring teeth involved with retruded contact position.


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