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Diagnosis and Restorative Management of Proximal Carious Lesions of Permanent Teeth using Elastic Separators. Description of the Technique and 2 Case Reports

Author(s): Berdouses EB, Sifakaki M, Lagouvardos P, Oulis CJ

Introduction and Aim: The management of the proximal cavitated carious lesions in permanent molars has been a challenge for the clinician in terms of integrity of the tooth, aesthetics and longevity of the restoration. The purpose of these case reports is to present a new technique for the management of proximal cavitated carious lesions of permanent teeth and to discuss the indications and benefits along with the problems and contraindications encountered in the clinical practice.

Case Reports: Two representative cases are presented in this paper among many others managed with this new approach. Case 1 refers to a 12 year old patient radiographically diagnosed with ICCMS stage 2 lesion on the right maxillary first permanent molar. Case 2 refers to a 15 year old radiographically diagnosed with ICCMS stage 3 and 4 lesion on the right maxillary and mandibular first permanent molars, respectively. The steps of the technique are described in detail and indications and benefits are presented along with contraindications and disadvantages of the technique. These two cases are part of a bigger study of 177 restorations followed for a median time of 4.3 years showing very similar results with class II restorations.

Conclusions: It is a technique that can correctly answer the question “cavitation or not” supporting the clinician’s decision to apply prevention or surgical intervention for the interproximal surface. It produces interdental space that can facilitate the restoration of the interproximal surface only leaving the occlusal intact. It is a technique that complies with the concept of minimal invasive dentistry showing very similar results with the class II amalgam restorations and betted results of composite ones.

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