Management of Proximal Caries in a Mandibular Molar with Class II Composite Restoration: A Case Report

Managing dental caries which involves proximal surface of posterior teeth, is quite challenging and demands a skillful approach. While restoring such carious lesions secondary retention is also given, to ensure better treatment outcome. In this case report, a successful management of a carious lesion in tooth #46, which is a mandibular molar is done. The management involves a direct class II composite restoration. The patient, a 26-year-old male, reported with discomfort during mastication. A proximal carious lesion was confirmed on the basis of clinical and radiographic examination. The caries was extending into dentin on the mesial aspect of tooth #46. The treatment started with isolating the tooth, by using rubber dam. After isolation, caries removal was achieved. Before starting with placing composite, a sectional matrix and a wedge were inserted to ensure restoring the proximal wall contour and contact. A direct composite technique which includes using a nanohybrid composite resin was performed in increments to make sure that optimal adaptation and polymerization shrinkage is achieved. Final assessment of treatment was done with post operative radiograph, which confirmed that an ideal marginal seal was achieved, along with an established contact area. Furthermore, it was also confirmed by the radiograph that anatomical contours are restored. The case explains well the importance of careful caries removal, appropriate use of matrix systems and layering of composite material in managing proximal caries. The case also highlights that predictable esthetics and durable results in posterior teeth is achieved by using modern adhesive techniques and light cured composites.