CATEGORY 62 AUSTRALASIAN DENTIST Background A 47-year-old female patient attended the dental practice concerned about the discoloration of a posterior tooth. The patient did not report any pain or sensitivity. Radiographic examination confirmed the presence of a mesial carious lesion on tooth #45. Procedure Clinically, a defective restoration and the presence of a carious lesion were observed on the occlusal surface. After local anesthesia, absolute isolation was performed using a Nic Tone medium rubber dam. The carious lesion was removed Simplifying class II restorations without an adjacent tooth: A Garrison ReelMatrix approach case study By Dr María José Naranjo Cabezas Dr María José Naranjo Cabezas Figure 1: Radiographic examination confirmed the presence of a mesial carious lesion on tooth #45. Figure 4: The carious lesion was removed using a high-speed handpiece, followed by manual caries excavation with a dentin excavator. Figure 2: Clinically, a defective restoration and the presence of a carious lesion were observed on the occlusal surface. Figure 5: After cavity disinfection with 2% chlorhexidine, TheraCal was applied to the deepest area, closest to the pulp horn, and light-cured. Figure 3: After local anesthesia, absolute isolation was performed using a Nic Tone medium rubber dam. Figure 6: Selective enamel etching was performed with 35% phosphoric acid for 15 seconds, followed by rinsing for twice the etching time and gentle drying. using a high-speed handpiece, followed by manual caries excavation with a dentin excavator. After cavity disinfection with 2% chlorhexidine, TheraCal was applied to the deepest area, closest to the pulp horn, and light-cured. Selective enamel etching was performed with 35% phosphoric acid for 15 seconds, followed by rinsing for twice the etching time and gentle drying. Two coats of universal adhesive were applied with active scrubbing, air-blown between each coat, and then light-cured. A 0.5 mm layer of flowable composite resin was placed on the floor and walls of the cavity and light-cured. The Garrison ReelMatrix™ matrix was then positioned, and a matrixin-matrix technique was used to achieve better sealing. The proximal wall was built using the snowplow technique. Once the Class II cavity was converted into a Class I cavity, the restoration was completed using a horizontal incremental technique with Tetric N-Ceram A2, light-curing each increment with a curing unit delivering 1200 mW/cm². After rubber dam removal, high occlusal contacts were identified and adjusted. Finally, the restoration was finished and polished. Tooth #44 will be restored at a subsequent appointment. CLINICAL
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