Conservative Amalgam Replacement and Class I Restoration

The figures present two cases featuring Class I restorations. The first case involves retreatment of a properly executed amalgam restoration with cuspal fracture—a common clinical scenario. Although conventional treatment usually entails placement of an indirect restoration, a stress-reduced direct composite restoration can be a predictable option if proper adhesive techniques are employed. A fiber mesh was used to mitigate the stresses associated with composite polymerization shrinkage and to function as a fail-safe for the compromised tooth.

In the second case, a conservative intervention is employed to restore moderate occlusal caries. Instead of utilizing strict G.V. Black preparation designs, the caries was removed in a manner in which the sound occlusal tooth structure was maximally preserved in order to mitigate potentially damaging tooth flexure under load. A fiber reinforced composite material was used in the restoration to help manage the shrinkage stresses in this conservative preparation.

Jihyon Kim, DDS
Private Practice
Seattle and Bellevue, Washington