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.