A patient presented with a posterior tooth previously treated endodontically, showing deep occlusal and proximal carious involvement with loss of tooth structure and compromised coronal integrity. The tooth was asymptomatic, and the main treatment objective was to re-establish an adequate coronal seal while preserving as much remaining tooth structure as possible
Endodontically treated teeth are more vulnerable to fracture and microleakage, especially when extensive occlusal and proximal caries are present. In such cases, the restorative plan should focus on:
- complete removal of infected carious tissue
- preservation of sound tooth structure
- reinforcement of weakened cusps and proximal walls
- achievement of a durable adhesive seal
- After proper isolation, the carious tissues were removed and the cavity margins were refined. The remaining tooth structure was carefully assessed to ensure that all unsupported enamel was eliminated. A direct adhesive composite restoration was then placed using an incremental layering technique to rebuild the occlusal anatomy and proximal contour.Attention was given to:
- proper bonding protocol
- controlled polymerization shrinkage
- restoration of contact and emergence profile
- occlusal adjustment and polishing
- The final restoration provided a functional and esthetic result with good adaptation, proximal contact, and occlusal harmony. The tooth was successfully restored with an emphasis on long-term seal and structural support following RCT.
- ConclusionManagement of deep occlusal and proximal caries after root canal treatment requires a conservative but biologically sound approach. A well-executed adhesive restoration can effectively restore function, reinforce the remaining tooth structure, and improve the prognosis of the endodontically treated tooth.
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