Restore the "unrestorable" - adhesive solutions for subgingival situations

Adhesive restorations are not only standard of care, but offer a multitude of treatment possibilities.

Apart from their “classical” use in cavities of class I-V, composites can be used during repair procedures, reshaping of teeth, buildup of cusps – all under the aspect of minimal invasive intervention. Questions arise about the limitations for adhesive restorations. The most important factor by far is a dry working field, which can be achieved with rubber dam application and conventional matrix systems. This technique can be used in supra-and also for shallower sub gingival cavities, but often cannot be applied in deep subgingival cavities. With modifications of matrix systems and the use of other tools such as teflon tape instead of wedges, those defects can be restored adhesively under sufficient moisture control. This approach allows new restorative procedures like the “proximal box elevation” or “deep margin elevation” technique. The lecture addresses problems which arise during the adhesive restoration of deep subgingival defects and demonstrates how a dry working field can be reached with modification of existing techniques.