Art and science combined

Allan Matthews describes overcoming challenges when restoring a molar.

The flexing of cusps caused by excessive chewing force is one of the most frequent conditions I see in practice, where loading under tension may ultimately cause the tooth to crack and break. In addition, ditched margins are commonly associated with creeping of amalgam restorations. Such issues can be treated with a range of options, from the most minimally invasive composite filling restoration, through to indirect inlays, onlays and eventually a crown. Only by removing the existing amalgam can the extent of the challenge be understood, and the most appropriate treatment plan considered.

Patient presentation and diagnosis
A patient in his early thirties attended Integrated Dentalcare in Edinburgh as he was experiencing intermittent pain on biting with his upper left first molar, which had previously been restored with amalgam. There were no symptoms from thermal stimuli or sensitivity caused by sweet foods. The patient’s oral health was generally good but it had been a while since he had been seen by a dentist.