Name:

Ramzi Nazeh Ibrahim

ID:
88506

Sec:
11

Group:
2
  CLINICAL ASSESMENT:

- Inflamed gingiva (reddish)

- Thick gingival biotype
- No hyperplasia
- Sub-gingival cavity margin

 Radiographic assessment
- No radiographic record
- But radiographs is used to asses:
1- Periapical lesion
2- Biological width
3- Interproximal bone levels

Normal High Low

Sulcular depth + biological Less than 3mm More then 4.5mm

width = 3 to 4.5mm

Normal bone hight and Normal bone height and Limited bone height and
sulcular depth limited sulcular depth high sulcular depth

 Gingival Tissue Management:

- Gingivectomy by using laser to minimize bleeding

- Proper rubber dam isolation
- Using teflon tape or retraction cord
- Ligation should be Done with Active clamp ( 44 or B4 )

- Don’t use retraction cord if gingiva is heavily inflammed

- If it’s not heavily inflammed, Use retraction cord (braided) with hemostatic agent to
control bleeding
- Pre-wedging to provide separation with wooden wedge to absorb fluids

 Restorative Procedure:
- Remove all carious lesions and make bevel for improving strength of restoration
- Using resin modified glass ionomer as patients’s oral hygiene is bad.
- Using sectional or spoon matrix to make proper contact if carious lesion is extended to
proximal surface.
- Load the capsule in glass ionomer gun after put it in amalgamator for 6-8 sec.
- Keep the cavity dry, This is especially important because the glass ionomer sticks much
better to a dry cavity.
- Apply the capsule to the cavity and fill it with RMGI
- Remove any extra restoration from the tooth before it gets hard.
- Finish the restoration with finishing stone and discs
- Make sure the contact is good by using dental floss.

 Alternative material: Composite restoration with low modulus of elasticity with shade
A3 or A3.5 (Not preferred because of bad oral hygiene of patient).
 Using Closed gap technique to reduce debonding stresses or twin anterior matrix.
 Unica matrix may be with good value.