Introduction
Class V lesions occur at the cervical third of the tooth, typically on the buccal or lingual surfaces. Their etiology can be multifactorial, including:
- Dental caries
- Abrasion (e.g., aggressive tooth brushing)
- Erosion (acidic exposure)
- Abfraction (occlusal stress)
These lesions present both functional and esthetic challenges, especially due to their proximity to the gingival margin.
Diagnosis
Accurate diagnosis is critical and should include:
- Visual assessment (color, cavitation, surface texture)
- Tactile examination
- Patient-reported sensitivity
- Differentiation between carious and non-carious lesions
This distinction directly influences the treatment strategy.
Treatment Planning
Composite resin is the material of choice in many Class V cases due to:
- Superior esthetics
- Conservative tooth preparation
- Adhesive capabilities
However, case selection must consider moisture control and margin location.
Clinical Procedure
1. Shade Selection
Performed prior to isolation to ensure accurate color matching, especially important in cervical regions which tend to be slightly darker.
2. Isolation
- Rubber dam is ideal
- Alternatives: cotton rolls with gingival retraction
Proper isolation is essential for optimal bonding.
3. Cavity Preparation
- Minimal invasive approach
- Removal of infected dentin only
- Enamel beveling (when esthetics are critical)
4. Gingival Management
- Use of retraction cord or gingival barrier
- Ensures clear access and prevents contamination
5. Etching
- Total-etch or selective enamel etching
- Enamel: 15–20 seconds
- Dentin: ~10 seconds (if total-etch technique is used)
6. Bonding
- Application of an appropriate adhesive system
- Gentle air thinning and adequate light curing are crucial
7. Composite Placement
- Incremental layering technique
- Reduces polymerization shrinkage
- Allows better control of contour and adaptation
8. Finishing and Polishing
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