Discussion
carious, tightness, carious tooth, caries
CAVITY, PCT, CARIES, IMPACTION
One of the most overlooked topics in posterior composite restorations is the interdental anatomy of a class II direct composite restoration. Promoting arch continuity and reducing impaction of foods must be the goals of the reconstructing of proximal contact. [The international caries detection and assessment system “ICDAS” was employed to the current investigation as an evidence-based clinical scoring system [In the present study, proximal contacts between the first permanent molar and second premolar were selected to be restored in all treated patients as they were found to have the tightest proximal contacts within a dental arch as concluded Dorfer et al. [Traditionally, to ensure proper proximal contact tightness, dental floss is used, and the proximal tightness is checked by permitting the passing of floss to a snap [Sectional matrix systems with separating rings were shown to produce higher PCT than circumferential matrix bands as concluded by many studies [To the best of our knowledge, there is no available documented clinical data concerning evaluation of PCT using transparent contact forming instruments in combination with sectional matrix system. Therefore, this in vivo research was conducted to evaluate the PCT while using the sectional matrix system alone or in conjunction with different transparent contact forming instruments.The study results revealed a tighter proximal contact with all matrices in comparison to baseline. There is a possibility that the tighter proximal contact may have been generated by a larger contact area produced by the matrices compared with the prior tooth structure that was indeed carious. Palodent Plus matrix system was utilized in all groups. This matrix system is designed to provide a standardized and anatomically shaped form for the restoration, which may contribute to creating a more consistent and well-shaped proximal surface compared to the carious tooth structure [Furthermore, trimax system showed significantly higher PCT than other tested contact forming instruments. This might be related to instrument geometry with its convex prongs that could simulate physiologic contacts in a more anatomical way. It was also presented as a full kit including many replaceable tips with different sizes that can accommodate in any cavity unlike other contact forming instruments that have fixed tips. This comes is in line with El-Badrawy et al. [Moreover, the influence of a restorative intervention on the proximal contact was investigated during a period of 12 months. The PCT between Class II composite resin restorations and adjacent teeth was significantly decreased and generally reached the level of PCT between natural teeth. However, the proximal contacts at the natural premolar teeth showed no significant differences in tightness during the 1 year follow up period. Thus, it is likely that the observed differences in contact tightness at the treatment side are due to the restorative intervention. These findings are in accordance with Loomans et al. [In contrast to our findings, Prakki A et al. [While this study has provided significant insights into PCT in direct Class II composite resin restorations, it’s crucial to recognize its limitations. The follow-up period was restricted to 12 months, and extending this duration would provide a more comprehensive understanding of how PCT may evolve over time. Moreover, this study concentrated on mesio-occlusal surface restoration for better standardization, but future investigations exploring different cavity design and matrix systems may provide further valuable insights. Additionally, future research should encompass an assessment of how these instruments influence not just PCT but also the precise location of proximal contacts, as this aspect was not fully addressed in our study. Despite these limitations, the study provides a valuable foundation for further research in this area, highlighting the importance of PCT in maintaining dental health. It is worth noting that throughout the course of the study, there were no instances of loss of follow-up or discontinuation of the intervention among the enrolled participants. This level of participant retention strengthens the study’s internal validity and the credibility of its findings. Future studies with larger cohorts and longer follow-up periods can build upon these findings to enhance our understanding of optimal restoration techniques and materials.