If earlier, in the treatment of caries and its consequences, doctors were content with simply replacing damaged tissues using various filling materials (such as silicophosphate, silicate cements, amalgams), nowadays their tasks have become more complex. For example, it is no longer sufficient to just restore a damaged tooth and its shape. It is also important to prevent possible complications (such as recurrent caries and others), improve the aesthetic characteristics of the tooth, restore its functional value, and biomechanical properties.
What is a contact point:
The contact point is the contact of adjacent (lateral) surfaces of neighboring teeth. Over time, the contact point undergoes changes: starting as a point during eruption, it becomes flat due to the physiological mobility of teeth, leading to natural wear of the contact surfaces.
Role of the contact point:
- Divides food on both sides of the tooth and prevents the entry of food into the interdental space.
- Prevents damage to the interdental papilla and interalveolar septum.
- Holds the teeth in a specific position relative to each other, ensuring uniform stability of their position in the dental arch.
- Distributes chewing pressure.
The area where one tooth interacts with another is defined as the area of tooth contact. This method of restoring the contact point (Class II according to the Black classification) involves the use of various materials, such as amalgam, composites, compomers, as well as combined materials, representing a combination of composite and glass fiber material.
Restoration of tooth contact points:
During the treatment of masticatory teeth, the dentist often encounters defects of Class II according to Black. However, one of the most challenging tasks is the restoration of the contact point. This includes recreating several elements:
- The form of the contact point’s marginal ridge;
- The actual contact point;
- The triangular opening in the gingival area formed by wedges.
The formation of the contact point is carried out using various matrices (metal, plastic, and so on) and matrix systems. It is important to consider the thickness of the matrices, as metal matrices usually have a thickness of 35-40 microns, plastic matrices – 50 microns, while the width of the natural contact point is approximately 10 microns. Therefore, it is necessary to carefully choose matrices according to the specific clinical situation, especially when restoring mesio-occlusal-distal cavities, where matrices are required on both sides of the tooth.
Technologies for restoring contact points:
The “sandwich” technology is based on the concept of creating a two-layer filling, presented in two application options: “closed” sandwich, where the insert is completely covered with composite and does not interact with the oral cavity, and “open” sandwich, where the insert interacts with the oral cavity. In the case of Class II cavity treatment, the “open” option is preferable due to insufficient isolation from gingival fluid in the gingival and subgingival areas.
The Bertolotti method involves the introduction of chemically curable composite to a depth of 2/3 of the cavity after adhesive preparation. The composite shrinkage is directed towards the pulp due to increased temperature. Then, without waiting for complete material curing, 1/3 of the cavity is filled with photocomposite and polymerized.
The variety of matrices by shape includes flat types (metal strips/transparent from Lavsan, metal strips/transparent from Lavsan), anatomically shaped (metal stainless steel/titanium), perforated metal (polyester), combined, contour, and ring (stainless steel/titanium/polymer) sectional matrices, including matrices, fixing ring, and forceps for ring placement.
Quality control of restorative work includes:
- Removal of excess material,
- Checking occlusal contacts and marginal adaptation using floss or a probe,
- Contact assessment is done visually, with floss should be introduced with slight resistance.
The contact point is considered unsatisfactory if a gap is visible between the teeth or if floss is introduced without resistance. In case of patient complaints about food impaction or thread breakage when using floss, restoration is recommended to be replaced. The restoration of tooth contact points depends on the availability of the necessary tools and the doctor’s ability to apply them in a specific clinical situation.
If you have any questions or need consultation from a qualified specialist, contact the “Prizma” medical center. Our managers will schedule you for an initial consultation and answer all your questions.
044 425 13 13, 095 269 13 13, 067 411 13 13
