CASE REPORT - Proximal Contact Adjustment on Tooth #29

Use of ContacEZ Diamond Dental Strip restores interproximal relief* by eliminating excessive pressure between the restoration and the adjacent teeth, and complete marginal seating is achieved simply and easily.

It is extremely important to tell your dental lab to retain the natural contour and space between the adjacent teeth. The models should not be scraped. If scraping is desired, it should not exceed 0.10mm in thickness.

 Fig. 1) The crown was placed on the preparation and seated with finger pressure. The margin of the crown fit to the preparation perfectly, but there was pressure in the interproximal spaces because of overly tight proximal contact.

Fig. 1) The crown was placed on the preparation and seated with finger pressure. The margin of the crown fit to the preparation perfectly, but there was pressure in the interproximal spaces because of overly tight proximal contact.

 Fig. 2) The crown was lifted from the prepared tooth and rested passively between the adjacent teeth. There was a marginal opening due to overly tight contacts and it was found that the mesial margin had less opening, which indicated that there was more pressure in the mesial interproximal space.

Fig. 2) The crown was lifted from the prepared tooth and rested passively between the adjacent teeth. There was a marginal opening due to overly tight contacts and it was found that the mesial margin had less opening, which indicated that there was more pressure in the mesial interproximal space.

 The side with the edge of the crown margin closer to the prepared tooth surface is the side with the heavier proximal contact. When a crown has a very heavy proximal contact, a rotary instrument is recommended for gross adjustment.

The side with the edge of the crown margin closer to the prepared tooth surface is the side with the heavier proximal contact. When a crown has a very heavy proximal contact, a rotary instrument is recommended for gross adjustment.

 Fig. 3) The crown was slightly lifted and a ContacEZ Diamond Dental Strip was inserted into the mesial interproximal space that had the heavier contact. The crown was gently finger pressed. The ContacEZ Diamond Dental Strip was passed with the abrasive surface facing the crown, buccolingually 6 times. The crown seated with each pass of the ContacEZ Diamond Dental Strip.

Fig. 3) The crown was slightly lifted and a ContacEZ Diamond Dental Strip was inserted into the mesial interproximal space that had the heavier contact. The crown was gently finger pressed. The ContacEZ Diamond Dental Strip was passed with the abrasive surface facing the crown, buccolingually 6 times. The crown seated with each pass of the ContacEZ Diamond Dental Strip.

 The orientation of the diamond particles on the metal strip may initially limit the movement of the strip to one direction. The crown was visible through the opening of the ContacEZ Diamond Dental Strip. This opening allowed easy access for an additional instrument to press down the loose crown while the ContacEZ Diamond Dental Strip was passed buccolingually.

The orientation of the diamond particles on the metal strip may initially limit the movement of the strip to one direction. The crown was visible through the opening of the ContacEZ Diamond Dental Strip. This opening allowed easy access for an additional instrument to press down the loose crown while the ContacEZ Diamond Dental Strip was passed buccolingually.

 Fig. 4) Then the ContacEZ Diamond Dental Strip was moved to the distal part of the crown and inserted into the interproximal space. The ContacEZ Diamond Dental Strip was passed twice buccolingually. Because there was light resistance to the distal, it was not necessary to pass the strip more than twice.

Fig. 4) Then the ContacEZ Diamond Dental Strip was moved to the distal part of the crown and inserted into the interproximal space. The ContacEZ Diamond Dental Strip was passed twice buccolingually. Because there was light resistance to the distal, it was not necessary to pass the strip more than twice.

 Fig. 5) Again, the ContacEZ Diamond Dental Strip was moved to the mesial of the crown and inserted into the interproximal space. It was passed 5-6 times with light resistance to ContacEZ Diamond Dental Strip. The crown was seated completely to the margin of the preparation. The side with the most resistance to ContacEZ Diamond Dental Strip was the heavier contact side and may require more passes of the strip.

Fig. 5) Again, the ContacEZ Diamond Dental Strip was moved to the mesial of the crown and inserted into the interproximal space. It was passed 5-6 times with light resistance to ContacEZ Diamond Dental Strip. The crown was seated completely to the margin of the preparation. The side with the most resistance to ContacEZ Diamond Dental Strip was the heavier contact side and may require more passes of the strip.

 Fig. 6) A ContacEZ Diamond Dental Strip was then inserted into the distal interproximal space of the crown and was stripped twice to check for light resistance. The ContacEZ Diamond Dental Strip is flexible and accommodates the curvature of contact surfaces of adjacent teeth. The author's observation is that most of the contact surfaces are curved, not flat.

Fig. 6) A ContacEZ Diamond Dental Strip was then inserted into the distal interproximal space of the crown and was stripped twice to check for light resistance. The ContacEZ Diamond Dental Strip is flexible and accommodates the curvature of contact surfaces of adjacent teeth. The author's observation is that most of the contact surfaces are curved, not flat.

 Fig. 7) The ContacEZ Diamond Dental Strip was inserted into the mesial interproximal space for the third time and passed twice to check for light resistance.

Fig. 7) The ContacEZ Diamond Dental Strip was inserted into the mesial interproximal space for the third time and passed twice to check for light resistance.

 Fig. 8) The crown was cemented by firmly pressing down.

Fig. 8) The crown was cemented by firmly pressing down.

 Fig. 9) After removal of excess cement, interproximal relief was confirmed by passing ContacEZ Diamond Dental Strip through the interproximal space on both mesial and distal of the crown.

Fig. 9) After removal of excess cement, interproximal relief was confirmed by passing ContacEZ Diamond Dental Strip through the interproximal space on both mesial and distal of the crown.

 Fig. 10) Dental floss was used to confirm the firm proximal contacts of the crown. When the Interproximal Relief is achieved, dental floss passes through with firm resistance.

Fig. 10) Dental floss was used to confirm the firm proximal contacts of the crown. When the Interproximal Relief is achieved, dental floss passes through with firm resistance.

 Fig. 11) The occlusion was evaluated and adjusted. There was no extrusion of the adjacent teeth.

Fig. 11) The occlusion was evaluated and adjusted. There was no extrusion of the adjacent teeth.

 Fig. 12) Crown cementation was finished.

Fig. 12) Crown cementation was finished.

 Fig. 13) The occlusion of the quadrant of the crown was perfect. The patient said that she did not feel any pressure or changes in her mouth.

Fig. 13) The occlusion of the quadrant of the crown was perfect. The patient said that she did not feel any pressure or changes in her mouth.

Using ContacEZ Final Polishing Strip, the final proximal surface polisher (Gray), the mesial and distal proximal surfaces were polished.

*"A Proximal Contact Adjustment and Interproximal Relief Method"
The Journal of Prosthetic Dentistry, Vol.97, No.4, Page 244-245, April 2007, Daniel S Kim DDS FAGD and Kyu Won Suh DDS MSD DSO