26/01/2026
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Clinical Case: Rehabilitation of the Upper Left Quadrant (Teeth 24–27)
Following the initial clinical and radiographic examination of the upper left quadrant, several restorative and periodontal issues were identified.
Tooth 25 was previously endodontically treated and presented with a dislodged crown. Tooth 26 was also endodontically treated and showed gingival overgrowth on the distal aspect, secondary to a faulty restoration. Tooth 24 had old restorations with overhangs and improper contours, while tooth 27 exhibited mesial caries.
After isolation of the operative field, treatment was initiated with tooth 25. Caries removal and thorough cleaning were performed, followed by restoration using PA2 composite resin (Tokuyama). The tooth was properly finished and contoured.
Subsequently, attention was directed to tooth 26. A Tofflemire matrix band was placed, and the distal aspect was rebuilt first to re-establish proper contour and contact. The restoration was completed incrementally, restoring each surface individually. After finishing the distal surface, the mesial aspect was restored and finalized.
Once the direct restorations were completed, both teeth 25 and 26 were prepared for indirect E.max restorations. A digital scan was taken and sent to the laboratory for fabrication.
Upon delivery of the restorations from the laboratory, the teeth were isolated, and cementation was performed using a dual-cure resin cement (Tokuyama), ensuring proper seating and marginal integrity.
After successful cementation, restorative treatment was completed on teeth 24 and 27 to eliminate caries, correct faulty restorations, and achieve harmonious occlusion. This comprehensive approach restored function, improved periodontal health, and ensured optimal masticatory efficiency in the upper left quadrant.
Tokuyama_Dental
