Patient Details:

  • Age: 67 years old

Chief Complaint:

  • I feel sensitivity in my lower right tooth, especially when brushing or drinking cold water.

Clinical Examination:

Tooth Involved:

  • Tooth No. 44 (Mandibular Right First Premolar)

Findings:

  • Non-carious cervical lesion (NCCL)
  • V-shaped cervical abrasion
  • No mobility, no tenderness
  • No signs of pulpal or periapical pathology

Diagnosis:

  • Cervical Abrasion on Tooth 44 with dentin hypersensitivity

Treatment Plan:

  • Educate patient on proper brushing technique
  • Use of soft-bristled toothbrush and desensitizing toothpaste
  • Composite resin restoration for cervical abrasion on 44

Procedure:

  • Date of Treatment: [Insert Date]
  • Shade Selection: A3 (based on adjacent tooth shade)

Isolation:

  • Cotton roll isolation (rubber dam not used due to shallow lesion and accessibility)

Cavity Preparation:

  • Minimal preparation with fine diamond bur
  • Bevel placed at enamel margins for better blending
  • No local anesthesia used (as there was no pain)

Etching:

  • 37% phosphoric acid (15 sec enamel, 10 sec dentin)

Bonding Agent:

  • Applied as per manufacturer instructions and cured

Composite Placement:

  • Composite applied in increments
  • Sculpted to match natural contours
  • Light-cured each layer for 20 seconds

Finishing & Polishing:

  • Finishing burs and polishing discs used for a smooth surface

Post-operative Instructions:

  • Avoid abrasive brushing
  • Use desensitizing toothpaste for 2 weeks
  • Follow-up in 1 week to evaluate restoration and sensitivity

Discussion:

Cervical abrasions in older patients are often due to overzealous brushing or occlusal stress (abfraction component may also contribute). Composite resins provide a minimally invasive, esthetic, and durable solution when proper technique and isolation are ensured. Patient education is essential to prevent recurrence.

Conclusion:

Composite restoration of cervical abrasion in tooth 44 provided immediate relief from sensitivity and esthetic improvement. Ongoing prevention with proper brushing technique and regular dental reviews is advised.

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