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17 November 2021

Direct restoration of 4.6 and 4.7: a clinical case

Author: Alessandro Pezzana


The patient is a woman and she is 24 years old. She arrived in my office for a first visit.

From a medical point of view she has nothing to report if not a mild allergy related to the latex.

The remote stomatognathic history tells of a fixed orthodontic treatment, scaling once a year, and some fillings received during adolescence.

From a dental point of view, the young patient is in first skeletal and dental class, has no symp-toms or signs of periodontal disease and plaque control, even if not perfect, is very good.

The patient reports slight discomfort during ingestion of sweet foods or drinks and during chew-ing on the 4th quadrant.

During the visit, consisting of the physical examination and instrumental examinations such as radiographs bitewings, thermal tests and compression tests (to exclude the presence of typical symptoms of a crack) at the level of the fourth quadrant, she has: amalgam restoration on dental element 4.6 associated with primary mesial caries and primary occlusal caries on 4.7.

The symptoms are not clearly identifiable by the patient but they can be traced back to dental elements 4.6 through diagnostic tests.

The quadrant is rehabilitated through direct composite procedures.


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