Question

"Patient: Female, 38-years-old.

Chief complaint: ""I was chewing and part of my tooth broke.""
Background/or patient history: Your patient is a regular attender, maintains good oral hygiene, and has a low caries risk. There are no relevant medical factors. She has a large mesio-occlusal (MO) composite restoration in tooth #3. This was placed by a previous dentist at least eight-years ago.
Current Findings: Apart from a sharp edge which is uncomfortable on her cheek, the patient has no symptoms. On examination, you find the mesiobuccal cuspof tooth #3 has fractured off supragingival. The tooth is vital and there is no evidence of caries. The occlusion is class I. After a discussion, you and your patient elect to restore tooth #3 today with a direct composite resin restoration, on the understanding that she will return in the coming months to restore the tooth definitively with a more durable ceramic restoration.

Following the removal of the existing restoration, you place a matrix and a wedge. In most instances you will wedge from the
a. Buccal side: to avoid the mesial concavity on the maxillary first molar
b. Lingual side: because this applies better pressure on the mesiolingual root
c. Buccal side: because it is more convenient
d. Lingual side: because this achieves better adaptation of the matrix to the gingival margin"

Answer 1

The preferred placement of the wedge when restoring a tooth with a direct composite resin is from the lingual side to ensure better adaptation of the matrix to the gingival margin.

Step-by-step explanation:

When placing a matrix and wedge for a direct composite resin restoration on tooth #3, it is generally preferred to wedge from the lingual side because this achieves better adaptation of the matrix to the gingival margin.

This technique enhances the contour of the restoration by providing proper pressure and matrix adaptation, which is critical for the longevity of the restoration and the health of the neighbouring gingival tissue. In this specific case of restoring the mesio-occlusal (MO) composite restoration for a fractured mesiobuccal cusp, proper wedge placement is essential for a successful temporary restoration, until the patient can receive the more durable ceramic restoration.