CONTENTS

INTRODUCTION
DEFINITION
IDEAL CONTACTS AND CONTOURS
ROLE OF CONTACTS AND CONTOURS
CAUSES OF IMPROPER CONTACTS, CONTOURS,
EMBRASSURES, MARGINAL RIDGES
HAZARDS
HISTOPATHOLOGY OF THE EFFECTED TISSUES
PROCEDURES FOR FORMULATION OF PROPER CONTACTS
AND CONTOURS
CONCLUSION
REFERENCES
CONTACT AREAS AND CONTOURS
INTRODUCTION:
From the carioe!ic a"#ect there ma$ %e o!&$ '( occ&)"a& ")r*ace" %)t there
are +( co!tacti! #ro,ima& a!- +. *acia& a!- &i!)a& ")r*ace" ")"ce#ti%&e to carie"
mai!&$ -)e to *a)&t$ i!terre&atio!"hi# %et/ee! the co!tact area", mari!a& ri-e",
em%ra")re" a!- the i!i0a1
Deca$ o! the *acia& a!- &i!)a& ")r*ace" i" e"#ecia&&$ i! the i!i0a& 234
r-
#rimari&$ %$ *a)&t$ i!terre&atio! %et/ee! the tooth co!to)r a!- the #erio-o!ta&
com#o!e!t"1
From the #erio-o!ta& a"#ect, #erio-o!titi" ma$ a&"o %e ca)"e- %oth
i!ter#ro,ima&&$ a!- i! the *acia& a!- &i!)a& #erio-o!ti)m %$ the"e *a)&t$
i!terre&atio!"hi#"1
The 5e$ to the"e #ro#er re&atio!"hi#" i!ter#ro,ima&&$ i" the co!tact area a!-
*acio&i!)a&&$ are the occ&)"oi!i0a& a!- me"io-i"ta& co!*i)ratio!1
Contact Area:
The co!tact area i" the "ite o* act)a& co!tact %et/ee! t/o teeth o! the
me"ia& a!- -i"ta& ")r*ace" a!- i" erro!eo)"&$ ca&&e- a co!tact #oi!t1
Thi" i" the area o* heiht o* co!to)r o* the me"ia& a!- -i"ta& ")r*ace" o* a
tooth1 Some a)thor" -e"cri%e the co!tact a" 6mar%&e t$#e7 o* re&atio!"hi#1 The
co!tact #oi!t %ecome" a co!tact area %eca)"e o* /ear o* o!e #ro,ima& ")r*ace
aai!"t a!other -)ri! #h$"io&oic tooth mo0eme!t /hich re")&t" i! a *&atte!e-
co!tact area o* ' or 4mm i! #o"terior teeth a!- "&iht&$ "ma&&er i! a!terior teeth1
'
Height of Contour:
The heiht o* co!to)r i" the area o* reate"t circ)m*ere!ce o! the *acia& a!-
&i!)a& ")r*ace" o* the tooth1
Embrasures:
Pro,ima& c)r0at)re" a-8ace!t to the co!tact area *rom 9:"ha#e- "#i&&/a$
"#ace" ca&&e- Em%ra")re"1 The "#ace" that /i-e! o)t *rom the area o* co!tact are
&a%ia& or %)cca& a!- &i!)a& em%ra")re"1 A%o0e the co!tact area" occ&)"a&&$ are the
i!ci"a& or occ&)"a& em%ra")re" a!- %e&o/ the co!tact area" are the i!i0a&
em%ra")re" /hich are *i&&e- /ith the i!ter-e!ta& #a#i&&a1
Emergency Profie:
The #art o* the a,ia& co!to)r that e,te!-" *rom the %a"e o* the i!i0a&
")&c)" #a"t the *ree mari! o* the i!i0a ha" %ee! -e"cri%e- a" the emere!ce
#ro*i&e %$ "tei! a!- 5)/ata1 The emere!ce #ro*i&e e,te!-" to the heiht o*
co!to)r #ro-)ci! a "traiht #ro*i&e i! the i!i0a& thir- o* the a,ia& ")r*ace1
Contact areas !"ucca an# Occusa As$ect%:
Accor-i! to their e!era& "ha#e", teeth ca! %e -i0i-e- i!to 4 t$#e" /ith
each ha0i! it" o/! #h$"ica& characteri"tic" i! the co!tact area"1
21 Ta#eri! teeth
'1 O0oi- teeth
41 S;)are teeth
4
Contact Ta$ering O&oi# S'uare
21 I!ci"or" I!ci"a& ri-e" Me"ia& < = o*
cro/! i!ci"o
i!i0a&&$1
I!ci"a& ri-e"
La%io:&i!)a&&$ it i"
&a%ia&&$1
Di"ta& < 234
r-
to >
o* cro/! &i!)a&&$1
La%io:&i!)a&&$ it
i" i! the ce!ter1
'1 Ca!i!e Me"ia&:I!ci"a& ri-e
Di"ta& < Mi--&e
C&o"e to i!ci"a&
ri-e"
C&o"e to i!ci"a&
ri-e"
La%io:&i!)a&&$ it i" i!
the ce!ter
Ce!tre Ce!tre
41 Bic)"#i-" ?)!ctio! o* the occ&)"a&
a!- mi--&e 234
r-
1
Mi--&e 234
r-
Occ&)"a& 234
r-

La%io:&i!)a&&$ it i" at
the %)cca& a,ia& a!&e
?)!ctio! o* %)cca&
a!- mi--&e 234
r-

To/ar-" %)cca&
a,ia& a!&e
.1 Mo&ar"
me"ia&
co!tact
?)!ctio! o* the occ&)"a&
a!- mi--&e 234
r-
1
Mi--&e 234
r-
Occ&)"a& 234
r-

La%io:&i!)a&&$ it i" at
the me"io:%)cca& a,ia&
a!&e o* tooth1
?)!ctio! o* %)cca&
a!- mi--&e 234
r-

To/ar-" %)cca&
a,ia& a!&e
@1 Mo&ar"
-i"ta& co!tact
Di"ta& co!tact o*
ma!-i%)&ar *ir"t mo&ar
i" 0aria%&e -)e to the
#o"itio! o* -i"ta& c)"#1
Occ&)"o:i!i0a&&$ at
the mi--&e 234
r-

B)cco&i!a)&&$ at the
mi--&e 234
r-

Occ&)"o i!i0a&&$
at the mi--&e 234
r-

B)cco&i!)a&&$ i!
&i!e /ith the
ce!tra& roo0e o*
the occ&)"a&
")r*ace1
I* "ma&& co!tact
occ&)"a& 234
r-

&i!)a&&$1
I* &are co!tact
*rom &o/er %or-er
o* the mari!a&
ri-e to the CE?1
234
r-
to '34
r-
o* the
cro/! %)cco:
&i!)a&&$1
.
Pro(ima Contours:
21 Ta#eri! teethA: Pro,ima& co!to)r o* the ta#eri! t$#e o* teeth ha" o!e
commo! *eat)reA Starti! at the CE?, the ")r*ace #re"e!t" a co!ca0it$ a&mo"t to
the co!tact area" a!- the$ are -eci-e-&$ co!0e, *rom there to the cre"t o* the
mari!a& ri-e"1 The co!ca0itie" are more #ro!o)!ce- o! the me"ia& tha! o!
the -i"ta& ")r*ace"1 Co!ca0itie" occ)r mo"t *re;)e!t&$ o! the me"ia& ")r*ace" o*
teeth ha0i! %)cca& a!- &i!)a& root", mo"t #ro!o)!ce- %ei! the me"ia& o* the
*ir"t ma,i&&ar$ #remo&ar1
'1 S;)are teethA The #ro,ima& co!to)r" o* ";)are t$#e teeth ha0e a te!-e!c$ to
%ecome a #&a!e i!"tea- o* a c)r0e- ")r*ace1 B)cco&:&i!)a& co!ca0itie" are
*o)!- occa"io!a&&$ o! the me"ia& ")r*ace" o* the ma,i&&ar$ *ir"t %ic)"#i-", *ir"t
a!- "eco!- mo&ar", a!- the me"ia& ")r*ace o* ma!-i%)&ar *ir"t mo&ar1 The -i"ta&
")r*ace" are e!era&&$ either *&at or "&iht&$ co!0e,1 The co!0e,it$ /hich
create" the mari!a& ri-e" -i"a##ear at the co!tact a!- the remai!-er o* the
")r*ace i! the i!i0a& -irectio! i" )")a&&$ *&at1
41 O0oi- teethA Pro,ima& co!to)r" o* o0oi- a!terior teeth are co!0e, *rom the
i!ci"a& a!&e to the CE?1 Bic)"#i-" o* the o0oi- t$#e are *re;)e!t&$ %e&& "ha#e-
/ith the co!0e, ")r*ace r)!!i! *rom the cre"t o* the mari!a& ri-e" a&mo"t to
the CE? /here the$ mere 0ia a "&iht&$ co!ca0e ")r*ace to a )!io! /ith the
root ")r*ace"1 The me"ia& ")r*ace" o* o0oi- mo&ar" #re"e!t co!0e, area" /hich
are &e"" e,te!"i0e tha! tho"e o! -i"ta& ")r*ace"1
@
)acia an# *ingua Contours:
I! a 0ertica& -irectio!, a&& tooth cro/!" /i&& e,hi%it "ome co!0e, c)r0at)re"
occ&)"a& to the cer0ica& &i!e1 Thi" c)r0at)re i" "ometime" ca&&e- the cer0ica& ri-e1
The e,te!t o* c)r0at)re" 0arie" i! -i**ere!t i!-i0i-)a&" %)t -oe" !ot e,te!- more
tha! 2mm %e$o!- the cer0ica& &i!e1
A&tho)h i!ci"o:a#ica& c)r0at)re o* the *acia& a!- &i!)a& ")r*ace" o* a&&
teeth i" co!0e,, the i!ci"a& > to 234 o* the &i!)a& ")r*ace" o* a!terior teeth
-i"#&a$" "ome co!ca0itie", more #ro!o)!ce- /ith )##er ce!tra&" a!- &atera&"1 The
ca!i!e" "ho/ more co!0e,it$ o! the *acia& ")r*ace tha! the ce!tra&" a!- &atera&"1
I! #o"terior teeth there /i&& %e a me"io:-i"ta& co!0e,it$ corre"#o!-i! to each
c)"#1 I! mo&ar" /here there i" more tha! o!e c)"# %)cca&&$ a!- &i!)a&&$, the"e
co!0e,itie" are i!terr)#te- %$ co!ca0itie" at the occ&)"a& > to '34
r-
o* the cro/!1
The co!0e,it$ -ecrea"e" a" /e a##roach CE? a!- /i&& *&atte! or %ecome co!ca0e,
e"#ecia&&$ i* the cro/! ")r*ace 8oi!" a %i*)rcatio!1
The c)r0at)re" o! the &a%ia&, %)cca& a!- &i!)a& ")r*ace" o* a&& ma,i&&ar$
a!- %)cca& ")r*ace o* ma!-i%)&ar #o"terior teeth are a&mo"t )!i*orm, a%o)t (1@ mm
or &e""1 Ma!-i%)&ar a!terior teeth ha0e &e"" c)r0at)re tha! a!$ other teeth a!-
"ometime" it i" har-&$ -i"ti!)i"ha%&e1 Ma!-i%)&ar #o"terior teeth /i&& ha0e a
&i!)a& c)r0at)re o* a##ro,imate&$ 2mm, /ith the cre"t o* the c)r0at)re at the
mi--&e 234
r-
i!"tea- o* cer0ica& 234
r-
, thi" i" -)e to the &i!)a& i!c&i!atio! o* the
teeth1
+
Embrasures:
21 Ta#eri! t$#eA: The$ "ho/ reat 0ariatio! tha! other t$#e"1 I!ci"a& a!- &a%ia&
em%ra")re" are a&mo"t !e&ii%&e1 The i!i0a& a!- &i!)a& em%ra")re"
%et/ee! a!terior teeth are the /i-e"t a!- &o!e"t i! the mo)th1 B)cca&
em%ra")re" are "ma&&1 Li!)a& em%ra")re" are &o!, /ith me-i)m /i-th1
Gi!i0a& em%ra")re" %et/ee! #o"terior teeth are %roa- a!- &o!1
'1 S;)are t$#eA: I!ci"a&, &i!)a&, occ&)"a& a!- %)cca& em%ra")re" are !i&1 Gi!i0a&
em%ra")re" are a&mo"t !ot !oticea%&e, i* *o)!-, the$ are 0er$ !arro/ a!- *&at1
Li!)a& em%ra")re" are 0er$ !arro/ a!- &o!1
41 O0oi- t$#eA: I!ci"a&, %)cca&, &a%ia& a!- occ&)"a& em%ra")re" are /i-er a!-
-ee#er tha! other"1 Gi!i0a& a!- &i!)a& em%ra")re" are "hort a!- %roa-1
Roe of Contact Areas:
A #o"iti0e re&atio!"hi# "ho)&- e,i"t %et/ee! the co!tact" to re"i"t *oo-
im#actio! a!- to #rotect the i!i0a& ti"")e1 Thi" re&atio!"hi# ca! %e te"te- %$
#a""i! -e!ta& *&o"" %et/ee! the teeth a!- o%"er0i! the re"i"ta!ce /he! the *&o""
i" mo0e- *rom the i!i0a %et/ee! the t/o e!ame& ")r*ace"1
Pro,ima& co!tact" a!- i!ter-iitatio! o* the teeth thro)h occ&)"a& co!tact"
"ta%i&iBe" a!- mai!tai!" the i!terit$ o* the -e!ta& arche"1 Cith the i!crea"i! ae
the co!tact area" %ecome /i-e a!- *&at -)e to #h$"io&oic /ear a!- it i" -i**ic)&t
to c&ea! the"e area" /hich miht &ea- to #erio-o!ta& #ro%&em"1
D
Roe of contours:
E"#ecia&&$ the *acia& a!- &i!)a& ")r*ace" heiht o* co!to)r a**or-" the
#rotectio! a!- "tim)&atio! o* the ")##orti! ti"")e" -)ri! ma"ticatio!1 I! ca"e o*
a!terior teeth &a%ia& a!- the #ro,ima& co!to)r" #&a$ a! im#orta!t ro&e i! e"thetic"1
Roe of embrasures:
The o)t&i!e *orm o* re"toratio! /i&& i!c&)-e the -i"ea"e- tooth "tr)ct)re a!-
e,te!- "o that the mari!" are &ocate- i! the em%ra")re *or c&ea!i! #)r#o"e"1
The *oo- #artic&e" that are !ot cr)"he- %et/ee! the teeth "&i-e thro)h the
em%ra")re" to the to!)e a!- are thr)"t %ac5 o!to the occ&)"a& ")r*ace" *or
ma"ticatio!1 I! thi" /a$ ma"ticatio! i" *aci&itate- %$ the &i!)a& em%ra")re" a!- to
a &e""er e,te!t %$ the *acia& em%ra")re"1
Roe of Emergence Profie:
Pro-)ctio! o* a "traiht #ro*i&e "ho)&- %e a treatme!t o%8ecti0e i! re"tori!
a tooth %eca)"e it *aci&itate" acce"" *or ora& h$ie!e mea")re"1 The "traiht #ro*i&e
i" ea"i&$ e0a&)ate- /ith a #erio-o!ta& #ro%e1
Thro)h the $ear", )!-)e im#orta!ce, #ro%a%&$ ha" %ee! attri%)te- to a
E#rotecti0eF ro&e o* the a,ia& co!to)r i! the cer0ica& reio!1 A" a re")&t, %oth
-e!ti"t" a!- -e!ta& tech!i;)e" *re;)e!t&$ create a %)&e /here there "ho)&- %e
!o!e, a" /e&& a" #&ace it a#ica&&$ i! the cer0ica& reio!1 S)ch re"toratio!" )")a&&$
#romote the acc)m)&atio! o* *oo- -e%ri" a!- #&a;)e a!- i!i0a& i!*&ammatio! i"
e!co)rae- rather tha! #re0e!te-1
G
Roe of +argina Ri#ges:
Mari!a& ri-e" #&a$ a! im#orta!t ro&e i! /ith"ta!-i! a!- -i""i#ati! the
occ&)"a& "tre""e"1 The correct *orm o* mari!a& ri-e com#ati%&e /ith the a-8ace!t
tooth a!- a&"o /ith it" o/! ")rro)!-i!" i" im#orta!t -)ri! car0i! o* #o"terior
re"toratio!1 A mari!a& ri-e "ho)&- a&/a$" %e *orme- i! t/o #&a!e" %)cco:
&i!)a&&$, meeti! at a 0er$ o%t)"e a!&e1 Thi" *eat)re i" e""e!tia& /he! a!
o##o"i! *)!ctio!a& c)"# occ&)-e" /ith the mari!a& ri-e1
A mari!a& ri-e /ith the"e "#eci*icatio!" i" e""e!tia& *or the %a&a!ce o* the
teeth i! the arch, the #re0e!tio! o* *oo- im#actio! #ro,ima&&$, the #rotectio! o*
the #erio-o!ti)m, #re0e!tio! o* rec)rre!t a!- co!tact -eca$ a!- *or he&#i! i!
e**icie!t ma"ticatio!1
Thi" -iaram i&&)"trate" the *)!ctio! o* the mari!a& ri-e"1 Force" 2 a!- ',
acti! o! t/o a-8ace!t mari!a& ri-e" /i&& ha0e their horiBo!ta& com#o!e!t" 2H
a!- 'H -ri0e the t/o teeth to/ar-" each other, th)" #re0e!ti! a!$ im#actio!
#ro,ima&&$, mai!tai!i! the me"io-i"ta& -ime!"io! o* the -e!ta& arch a!-
a!chori! the teeth aai!"t occ&)"a& em%ra")re" are re-)ce-, -)e to 0ertica&
occ&)"a& attritio! a!- *&atte!i! o* #ro,ima& co!tact area"1
Causes of Disturbances in Contact:
21 Ph$"io&oica& < mi-&i!e -ia"tema, "#aci!, rotatio!1
'1 P&)!er c)"#, *oo- im#actio!1
41 Fract)re o* teeth1
.1 Pro,ima& carie"1
@1 Ha%it" < U!!ece""ar$ tooth #ic5i!, #&aci! a !ai& or a !ee-&e %et/ee!
teeth1
H
+1 Im#ro#er ortho-o!tic *orce1
D1 ?a/ *ract)re
G1 Im#ro#er re"toratio! < im#ro#er ca0it$ #re#aratio!, im#ro#er matrici!,
im#ro#er /i-i!, o0erha!i! re"toratio!", im#ro#er co!to)ri! o* the
/a, #atter! o* a! arti*icia& cro/!1
H1 Mi""i! tooth < -ri*ti! o* teeth, ")#raer)#tio! o* o##o"i! teeth1
CAUSES O) DISTUR"ANCES IN CONTOUR:
21 Ph$"io&oica& /ear
'1 A%ra"io!, ero"io!
41 Fract)re o* teeth
.1 E!ame& h$#o#&a"ia
@1 Smooth ")r*ace carie"
+1 Im#ro#er re"toratio! < im#ro#er matrici!, o0erco!to)ri! o* re"toratio!,
o0erco!to)ri! o* the /a, #atter! o* a! arti*icia& cro/! e"#ecia&&$
cer0ica&&$ o! the %)cca& a"#ect1
Causes of #isturbances in embrasure:
21 Im#ro#er co!tact"
'1 Im#ro#er co!to)r"
41 Perio-o!ta& -i"ea"e
Causes of #isturbances in margina ri#ges:
21 Pro,ima& carie", *ract)re o* teeth
'1 P&aci! the co!tact" too i!i0a&&$ or occ&)"a&&$
2(
41 Im#ro#er re"toratio! < a%"e!ce o* mari!a& ri-e, creati! a mari!a& ri-e
!ot com#ati%&e i! heiht /ith the a-8ace!t tooth, a mari!a& ri-e /ith !o
a-8ace!t tria!)&ar *o""a, o!e #&a!e- mari!a& ri-e" i! %)cco:&i!)a&
-irectio!1
HA,ARDS O) I+PROPER CONTACT AREAS:
21 Co!tact area that i" too %roa-, %)cco:&i!)a&&$ or occ&)"o:i!i0a&&$ /i&&
cha!e the a!atom$ o* the tooth a!- the i!ter-e!ta& co&)m!1 The !orma& "a--&e
"ha#e- area /i&& %ecome %roa-e!e-1 Thi" i" the mo"t 0)&!era%&e area to
#erio-o!ta& -i"ea"e1 F)rthermore the"e %roa-e!e- co!tact" #ro-)ce" a!
i!ter-e!ta& area that i" -i**ic)&t to c&ea! a!- i" more ")"ce#ti%&e to -eca$1
Broa-e!i! o* co!tact re-)ce" the em%ra")re" /hich )")a&&$ &ea-" to im#ro#er
mo0eme!t or *&o/ o* ma"ticate- materia&1 Thi" &ea-" to a-he"io! o* -e%ri" a!-
#o""i%&e i!ter#ro,ima& im#actio! o* that -e%ri", /hich ca)"e" Ha&ito"i"1 D)e to
the #erio-o!ta& #ro%&em there ca! e0e! %e &o"" o* tooth1
'1 Co!tact area that i" too !arro/, %)cco:&i!)a&&$ or occ&)"o:i!i0a&&$ /i&&
a&&o/ the *oo- to %e im#acte- 0ertica&&$ or horiBo!ta&&$ o! the -e&icate
i!ter-e!ta& co&)m!1 Thi" /i&& &ea- to reater ")"ce#ti%i&it$ *or #&a;)e
acc)m)&atio! /hich i! t)r! #re-i"#o"e" to the "ame #erio-o!ta& a!- carie"
#ro%&em"1
41 Co!tact area #&ace- too %)cca&&$ or &i!)a&&$ /i&& re")&t i! *&atte!e- re"toratio!
at the e,#e!"e o* the %)cca& or &i!)a& em%ra")re"1
.1 Co!tact area #&ace- too occ&)"a&&$ /i&& re")&t i! a *&atte!e- mari!a& ri-e at
the e,#e!"e o* occ&)"a& em%ra")re1
22
@1 Co!tact area #&ace- too i!i0a&&$ /i&& i!crea"e the -e#th o* the occ&)"a&
em%ra")re" at the e,#e!"e o* the co!tact area" o/! "iBe or at the e,#e!"e o*
%roa-e!i! or im#i!i! )#o! the i!ter-e!ta& co&)m!1
+1 Loo"e or o#e! co!tact" ma$ %e ca)"e- %$ the occ&)"a& *orce" mo0i! the teeth
me"ia&&$ or -i"ta&&$1 It create" co!ti!)it$ o* the em%ra")re" /ith each other a!-
/ith the i!ter-e!ta& co&)m!1 The"e -e*ect" /i&& a&&o/ *or the im#actio! o* *oo-
a!- the acc)m)&atio! o* %acteria& #&a;)e /ith the accom#a!$i! #erio-o!ta&
a!- carie" #ro%&em"1
Ha-ar#s of Im$ro$er Contours:
21 Facia& a!- &i!)a& co!0e,itie"A Co!0e, co!to)r" o! the *acia& a!- &i!)a&
")r*ace" o* the teeth a**or- #rotectio! a!- "tim)&atio! to the ")##orti!
"tr)ct)re" -)ri! ma"ticatio!1 The$ -irect the *oo- to/ar-" the %)cca&
0e"ti%)&e, #a&ate or to!)e /hi&e "tim)&ati! the ")rro)!-i! "o*t ti"")e %$
e!t&e ma""ae rather tha! irritati! it1 O0erco!to)re- c)r0at)re" ca! create a
*a0ora%&e e!0iro!me!t *or the acc)m)&atio! a!- ro/th o* carioe!ic a!-
#&a;)e %acteria at i!i0a& mari!I a#ica& to the heiht o* co!to)r1 Thi" re")&t"
i! chro!ic i!*&ammatio! o* the i!i0a1
It ha" %ee! re0ea&e- that there i" a&/a$" more i!here!t -a!er i! o0erco!0e,
rather tha! )!-erco!0e, *acia& a!- &i!)a& ")r*ace"1
Morri", re#orte- the re"#o!"e o* i!i0a& ti"")e aro)!- teeth #re#are- *or
arti*icia& cro/!" /hich ha- &o"t their tem#orar$ cro/!" /ere *o)!- to %e
")rro)!-e- %$ hea&th$ i!i0a /itho)t #&a;)e i! the cer0ica& reio! com#are-
/ith a##ro,imati! )!#re#are- teeth1
2'
Commo!&$, #orce&ai! *)"e- to meta& cro/!" are o0erco!to)re- %eca)"e o*
i!a-e;)ate *acia& re-)ctio!1 S)ch a! o0erco!to)r i!ter*ere" /ith the "ea&i!
c)** e**ect o* i!i0a aai!"t the tooth a!- the "e&*:c&ea!"i! mecha!i"m o* the
i!i0a& ")&c)"1
'1 Facia& a!- &i!)a& co!ca0itie"A: Co!ca0itie" occ&)"a& to the heiht o* co!to)r
are i!0o&0e- i! the occ&)"a& "tatic a!- -$!amic re&atio!", a" the$ -etermi!e the
#ath/a$" *or teeth i! a!- o)t o* ce!tric occ&)"io!1 Mi"&ocate- co!ca0itie" /i&&
&ea- #remat)re co!tact" -)ri! ma!-i%)&ar mo0eme!t" a!- e,ce""i0e
co!ca0itie" ca! i!0ite e,tr)"io!, rotatio! or ti&ti! o* occ&)-i! c)"#a&
e&eme!t" i!to !o!:#h$"io&oic re&atio!" /ith o##o"i! teeth1
Co!ca0itie" a#ica& to the heiht o* co!to)r, thera#e)tica&&$ or #atho&oica&&$
e,#o"e- are e""e!tia& *or the #ro#er mai!te!a!ce o* the accom#a!$i! !e/
com#o!e!t" o* the a-8ace!t #erio-o!ti)m a!- m)"t %e i!itiate- i! a re"toratio!1
De*icie!t co!ca0itie" at the"e &ocatio!" ca! create re"toratio! o0erha!" a!-
e,ce""i0e co!ca0itie" -ecrea"e the cha!ce *or ")cce""*)& #&a;)e co!tro& i! the
e,treme&$ #&a;)e retai!i! area"1
41 Pro,ima& co!to)r"A I! a--itio! to creati! a #ro#er co!tact area, it i" a&"o
e""e!tia& to re"tore a #ro#er co!to)r a-8ace!t to the co!tact area1 The #ro,ima&
cro/! co!to)r" are e!era&&$ *&at or co!ca0e1 Thi" #ro0i-e" a-e;)ate
em%ra")re "#ace *or the i!ter-e!ta& i!i0a a!- a&&o/" room *rom #&a;)e
remo0a&1 The tra!"itio!a& &i!e a!&e i" a&"o e!era&&$ *&at or co!ca0e to *orm
the o#e!i! *or the em%ra")re "#ace a!- ho)"e the i!ter-e!ta& ti"")e1
Fa%ricati! a re"toratio! that -oe" !ot re#ro-)ce the co!ca0itie" a!-
co!0e,itie" /hich occ)r here !at)ra&&$ /i&& &ea- to re"toratio! o0erha!" a!-
24
)!-erha!", 0ertica& a!- horiBo!ta& im#actio! o* -e%ri" a!- im#i!me!t )#o!
the a-8ace!t #erio-o!ta& "tr)ct)re"1 Too !arro/ em%ra")re" #re-i"#o"e teeth
a!- ")##orti! "tr)ct)re" to hea0ier "tre""e"1 Too /i-e em%ra")re" o**er &itt&e
#rotectio! to the )!-er&$i! "o*t ti"")e1
Ha-ar#s of Im$ro$er +argina Ri#ges:
21 A%"e!ce o* mari!a& ri-e" i! the re"toratio!A B$ the a%"e!ce o* a mari!a&
ri-e, *orce 2 /i&& %e -irecte- to/ar- the #ro,ima& o* the a-8ace!t tooth1 The
horiBo!ta& com#o!e!t" o* *orce 2H a!- 'H /i&& te!- to -ri0e the t/o teeth
a/a$ *rom each other1 Mea! /hi&e the 0ertica& com#o!e!t 29 a!- '9 ca!
im#act the *oo- i!ter#ro,ima&&$1 The 0ertica& com#o!e!t 9' /i&& %e more tha!
re;)ire-, there ma$ occ)r "&iht ti&ti! o* the tooth B1
'1 A mari!a& ri-e /ith /i-e occ&)"a& em%ra")re"A E,aerati! the occ&)"a&
em%ra")re /i&& -irect *orce" 2 a!- ' o! a-8ace!t #ro,ima& ")r*ace" /ith the
horiBo!ta& com#o!e!t" 2H a!- 'H "e#arati! the teeth a!- the 0ertica&
com#o!e!t" 29 a!- '9 -ri0i! the -e%ri" i!ter#ro,ima&&$1
41 A-8ace!t mari!a& ri-e" !ot com#ati%&e i! heihtA I* a re"tore- mari!a& ri-e
i" hiher tha! the a-8ace!t o!e, it /i&& a&&o/ *orce A to /or5 o! the #ro,ima&
")r*ace o* the re"toratio!1 The horiBo!ta& com#o!e!t AH, /i&& -ri0e the
re"tore- tooth a/a$ *rom the co!tacti! tooth a!- the 0ertica& com#o!e!t /i&&
-ri0e the -e%ri" i!ter#ro,ia&&$1 There /i&& %e "ome "e#aratio! o* teeth a" the
")r*ace ho&- *orce B i" too "ma&& to co)!teract *orce A1
.1 A mari!a& ri-e /ith !o a-8ace!t tria!)&ar *o""aA I! thi" "it)atio! there are
!o occ&)"a& #&a!e" i! the mari!a& ri-e" *or the occ&)"a& *orce" to act )#o!, "o
2.
there are !o horiBo!ta& com#o!e!t" to -ri0e the teeth to/ar-" each other,
c&o"i! the co!tact1 F)rthermore, the 0ertica& *orce /i&& te!- to im#act *oo-
i!ter#ro,ima&&$1
@1 A mari!a& ri-e /ith !o occ&)"a& em%ra")reA The t/o a-8ace!t mari!a&
ri-e" act &i5e a #air o* t/eeBer" ra"#i! the *oo- ")%"ta!ce #a""i! o0er it1
Tho)h there /i&& !ot %e a!$ 0ertica& im#actio! o* *oo-, the co!to)r" im#act o*
hiher co!ce!tratio! o* 0ertica& com#o!e!t o* *orce" ma$ &ea- to cha!e" i!
a&0eo&ar %o!e a*ter "ometime1
+1 A thi! mari!a& ri-e i! it" me"io:-i"ta& %)&5 /i&& %e ")"ce#ti%&e to *ract)re or
-e*ormatio! &ea-i! to the #ro%&em" o* the #re0io)"&$ me!tio!e- *a)&t$
mari!a& ri-e1 A&"o, thi" thi!!e"" ma$ &ea0e either "ha&&o/ or -ee# a-8ace!t
*o""a or %)&5$ a!atom$ /ith the "ame #ro%&em"1
D1 A o!e #&a!e- mari!a& ri-e i! the %)cco&i!)a& -irectio! ca! create #remat)re
co!tact" -)ri! %oth *)!ctio!a& a!- "tatic occ&)"io!1 Thi" t$#e o* mari!a& ri-e
i!crea"e the -e#th o* a-8ace!t tria!)&ar *o""a, ma!i*$i! the "tre""e" i! thi"
area1 Moreo0er, the o!e #&a!e- mari!a& ri-e co)&- i!crea"e the heiht o* the
mari!a& ri-e i! the ce!tre, ma5i! it ame!a%&e to the a-0er"e e**ect" o*
horiBo!ta& com#o!e!t" o* *orce1 Li5e/i"e, o!e #&a!e- mari!a& ri-e /i&&
-e*&ect the *oo- "tream a/a$ *rom !orma&, #ro,ima& em%ra")re mo0eme!t"1
2@
HISTOPATHO*O./ O) THE A))ECTED TISSUES:
Im#er*ect *ormatio!, -e"tr)ctio! or im#ro#er re"toratio! o* the co!tact area"
Foo- Im#actio!
I!*&ammatio! o* ")#er*icia& Pro,ima& Carie"
ti"")e"
Ac)te or chro!ic
9a"omotor !er0e" o* the -ee#er
Perio-o!ta& "tr)ct)re" are *ir"t
"tim)&ate-, the! o0er"tim)&ate-
a!- *i!a&&$ -e#re""e- i! acti0it$
I!*ectio! o* "o*t ti"")e" a!- a-8ace!t %o!e
Tooth &o""
PROCEDURES )OR THE )OR+U*ATION O) PROPER CONTACTS
AND CONTOURS:
I0 Intra Ora Proce#ures:
For the #ro#er re#ro-)ctio! o* co!tact area" a!- co!to)r" o* the #re0io)"&$
-e"cri%e- #h$"io:a!atomica& *eat)re" o* teeth, t/o o#erati0e act" m)"t #rece-e the
re"torati0e #roce-)re1
21 Tooth mo0eme!t
'1 Matrici!
2+
10 Tooth +o&ement:
It i" the act o* either "e#arati! the i!0o&0e- teeth *rom each other, %ri!i!
them c&o"er to teach other or cha!i! their "#atia& #o"itio! i! o!e or more
-ime!"io!"1 Thi" i" -o!e i! or-er to *aci&itate the creatio! o* a #h$"io&oica&&$
*)!ctio!a& co!tact, co!to)r a!- occ&)-i! a!atom$ i! the re"tore- tooth1
O%8ecti0e" o* tooth mo0eme!tA:
a1 To %ri! -ri*te-, ti&te- or rotate- teeth to their i!-icate- #h$"io&oic
#o"itio!"1
%1 To c&o"e "#ace %et/ee! teeth i! ca"e o* o#e! co!tact"1
c1 I!tr)"io! or e,tr)"io!1
-1 To mo0e teeth *rom !o!:*)!ctio!a& &ocatio! to #h$"io&oica&&$ *)!ctio!a&1
e1 To mo0e teeth *or e"thetic"1
*1 To create a "#ace ")**icie!t *or the thic5!e"" o* matri, %a!-1
There are t/o #ri!ci#a& metho-" o* tooth mo0eme!tA:
21 Ra#i- '1 S&o/
i1 Ce-e metho- a1 Se#arati! /ire"
a1 E&&iot "e#arator %1 O0er"iBe- tem#orarie"
%1 Coo-e! or #&a"tic /e-e" c1 Ortho-o!tic a##&ia!ce"
ii1 Tractio! metho-
a1 No!:i!ter*eri! tr)e "e#arator
%1 Ferrier -o)%&e %o/ "e#arator
2D
20 +atricing:3
It i" a #roce-)re /here %$ a tem#orar$ /a&& i" create- o##o"ite to a,ia&
/a&&", ")rro)!-i! area" o* the tooth "tr)ct)re that /ere &o"t -)ri! #re#aratio!1
Di**ere!t t$#e" o* matrice" are )"e- *or -i**ere!t t$#e" o* ca0itie" a!-
-i**ere!t t$#e" o* materia&"1
E&auation of #ifferent matri( techni'ue:
A&tho)h there ha0e %ee! a 0er$ *e/ i!0e"tiatio!" co!-)cte- o! thi"
")%8ect, the *o&&o/i! o%"er0atio!" ca! %e ")mmariBe- *rom i!*ormatio! that i"
#re"e!t&$ a0ai&a%&e1 It i" c&ear that !o matri, tech!i;)e i" ca#a%&e o* the e,act
re#&icatio! o* !orma& a!atomic co!to)r" o* re"tore- teeth1 Ho/e0er, -e0iatio!"
*rom !orma& are "&iht i! a!$ matrici! #roce-)re i* #ro#er co!to)ri! a!-
/e-i! are )ti&iBe-1
Ce-i! i" )!i0er"a&&$ im#erati0e i! or-er to e&imi!ate cer0ica& *&a"h o*
re"torati0e materia&1 Thi" i" tr)e /ith a&& three t$#e" o* tooth "ha#e"1 A&tho)h
matri, co!to)ri!, i! the a%"e!ce o* /e-i!, #ro-)ce" a more ro)!-e- co!to)r
Je"#ecia&&$ o! ";)are:t$#e teethK, it -oe" !ot re-)ce cer0ica& o0erha!"1 Cith
ta#eri! t$#e teeth, ho/e0er a! acc)rate re#ro-)ctio! o* the #ro,ima& ")r*ace ca!
%e achie0e- /itho)t co!to)ri! i1e1, /e-e a&o!e ca! %e )"e-1 O0oi- t$#e teeth are
the mo"t -i**ic)&t to re#ro-)ce, "o that &i5e ";)are teeth, co!to)ri! i! a--itio! t
/e-i! i" re;)ire-1
O0erha!i! re"toratio!" ha0e &o! %ee! 0ie/e- a" a co!tri%)ti! *actor to
i!i0iti" a!- #o""i%&e #erio-o!ta& attachme!t &o""1 The$ #o"e a "i!i*ica!t
co!cer! a" their #re0a&e!ce ha" %ee! e"timate- at '@:D+L1 The "e0erit$ o* %o!e
2G
&o"" /a" -irect&$ #ro#ortio!a& to the "e0erit$ o* o0erha!"1 O0erha!" /ere
-e"i!ate- a" &are i* the$ occ)#$ M@2L o* i!ter#ro,ima& "#ace1 Sma&& a!-
me-i)m o0erha!" J'(:@(LK /hich /ere !ot a""ociate- /ith %o!e &o""1 The
o0erha!" !ot o!&$ i!crea"e the #&a;)e ma"" %)t a&"o i!crea"e the "#eci*ic
#erio-o!ta& #athoe!" i! the #&a;)e1 Mo"t o0erha!i! re"toratio!" ca! %e
reco!to)re-1 A "t)-$ -emo!"trate- that a micromotor -ri0e! -iamo!- ti# i" *a"ter
*or remo0i! o0erha!" a!- &e- to "moother re"toratio!" com#are- to "o!ic
"ca&er" a!- c)rette" JS#ri!5" et a&1 2HG+K1
Too ma!$ 0aria%&e" /ere )"e- to trim o0erha!" a!- to cha!e #ro,ima&
co!to)r" a*ter the remo0a& o* a matri, %)t i" -i**ic)&t to reco!to)r at thi" "tae1 It
/o)&- %e %etter to )ti&iBe a matri, tech!i;)e /hich /i&& mi!imiBe the cer0ica&
o0erha!" a!- im#ro#er co!to)r"1 E0e! /ith the #ro#er&$ cho"e! tech!i;)e, )"i!
*&o"" a*ter co!-e!"atio! o* ama&am -e*i!ite&$ im#ro0e" #ro,ima& co!to)r a" /e&&
a" re-)ce o0erha!"1
It /a" !otice- that the circ)m*ere!tia& matri, %a!-" retai!e- %$ tihte!i!
-e0ice" ha0e %ee! "ho/! to e&a"tica&&$ -e*orm tooth "tr)ct)re"1 Imme-iate&$ a*ter
remo0a& o* the matri, %a!-", tooth "tr)ct)re" the! reai! their orii!a& -ime!"io!,
re")&ti! i! a#" %et/ee! the tooth a!- the har-e!e- re"torati0e materia&1 The"e
a#" ma$ ra!e *rom 221. to '@ 1 The /i-th o* thi" a# i" -irect&$ #ro#ortio!a& to
the /i-th o* the #re#aratio!, the #re"")re a##&ie- /ith the matri, a!- the
#o"to#erati0e co!tractio! o* the #artic)&ar re"torati0e materia& )"e-1 Pa""i0e&$
i!"erte- matri, %a!-" &i5e a!atomic matri, a!- T:"ha#e- %a!-" etc1, ha0e !o
-e*ormati0e e**ect o! the remai!i! tooth "tr)ct)re"1
2H
Some e"thetic #ro%&em" ca! %e correcte- co!"er0ati0e&$ /itho)t the !ee-
*or tooth #re#aratio! a!- re"toratio! /hich i!c&)-e" attritio! o* i!ci"a& e-e", c&a""
I *ract)re o* ma,i&&ar$ a!terior"1 Co"metic co!to)ri! i" -o!e to achie0e $o)th*)&,
*emi!i!e characteri"tic" /hich i!c&)-e ro)!-i! o* i!ci"a& a!&e", re-)ci! *acia&
&i!e a!&e" a!- o#e!i! i!ci"a& em%ra")re"1
II0 E(tra Ora Proce#ures:
Co!tact" a!- co!to)r" are %etter mai!tai!e- %$ the e,tra ora& #roce-)re"
%eca)"e o* %etter acce"" a!- 0i"i%i&it$1
10 4a( Patterns:
Thi" i" )")a&&$ %)i&t i! a "&iht&$ o0erco!to)re- co!-itio!, e"#ecia&&$ at the
co!tact area to a&&o/ *or the *i!i"hi! a!- #o&i"hi! ")r*ace &o""e"1
Y)o-e&i" et a&1 J2HD4K -emo!"trate- that the reater the amo)!t o* *aca& a!-
&i!)a& %)&e o* a! arti*icia& cro/! the more the #&a;)e retai!e- at the cer0ica&
mari!1 I! a re0ie/ o* #erio-o!ta&:#ro"thetic i!teractio!", Bec5er a!- Na&-ah&
J2HG2K a0e a! o#i!io! that %)cca& a!- &i!)a& cro/! co!to)r" "ho)&- %e *&at a!-
!ot *at )")a&&$ O(1@mm /i-er tha! the CE?1
U!-erco!to)ri! tha! o0erco!to)ri! o* i!ter#ro,ima& re"toratio!" i"
#re*erre- a!- to #&ace co!tact area" a" *ar occ&)"a&&$ a" #o""i%&e a!- *)rthermore
to ma5e #o!tic" !arro/ i! or-er to *aci&itate acce"" *or i!ter#ro,ima& #&a;)e
co!tro& a" /e&& a" am#&e "#ace *or the i!ter-e!ta& #a#i&&a1
I! a #atie!t /ho"e i!i0a& mari!" are a#ica& to the ceme!toe!ame&
8)!ctio!, the ")&c)&ar mor#ho&o$ -i**er" *rom that o* a hea&th$ #atie!t /ho"e
i!i0a& mari!" o! e!ame&1
'(
Cama! ha" e"timate- the a!&e o* e!ame& *&are *rom the CE? to the
0ertica& a,i" o* the i!i0a& ho)"i! to %e a##ro,imate&$ ''1@1
A" the i!i0a& mari! #rore""e" more a#ica&&$, the ")&c)" !arro/" a!-
the i!tracre0ic)&ar co!to)r" o* the tooth %ecome the *&at co!to)r" o* the root rather
tha! the co!0e, ")r*ace o* the a!atomic cro/!1 I! thi" "it)atio! the i!tracre0ic)&ar
co!to)r" o* the arti*icia& cro/! -o !ot mimic the root %)t -e#e!- o! the a-8ace!t
i!i0a& mor#ho&o$1
Thi! i!i0a& re"#o!-" to irritatio! %$ recee-i! a!- thic5 i!i0a e!&are",
*orm" #oc5et" or %oth1
Che! i!tracre0ic)&ar mari!" are a-8ace!t to thi! i!i0a o! the root, the
")&c)&ar co!to)r" o* the arti*icia& cro/! "ho)&- %e *&at, mimic5i! the "ha#e o* the
root to #re0e!t o0erco!to)ri!1 I! the a!terior reio!, the !orma& *acia& co!to)r"
are ree"ta%&i"he- *or e"thetic", %)t thi" *&are o* the cro/! i" *ar a/a$ *rom the
i!i0a& mari! to a0oi- #&a;)e acc)m)&atio!1
Thi! i!i0a:root re&atio!"hi# /ith *&at emere!ce o* the root *rom the
i!i0a1 The "ame emere!ce a!&e re#ro-)ce- i! the arti*icia& cro/!1 E!ame&
%)&e i" a--e- ")#rai!i0a&1
The i!i0a a-8ace!t to the *&at root ")r*ace -e0e&o#" thic5 *ree i!i0a&
mari! /he! the )!-er&$i! %o!e i" thic5 a!- o*te! #re"e!t" /ith a "&iht, chro!ic
mari!a& i!i0iti" -e"#ite o* mi!ima& #&a;)e acc)m)&atio!1 I! the"e "it)atio!" it
ma$ %e a-0i"a%&e to create a thic5er i!tracre0ic)&ar cro/! "imi&ar to that o* a
!at)ra& cro/!1
'2
Thic5 i!i0a:root re&atio!"hi# /ith a !at)ra& cro/! a!- the arti*icia&
cro/! i!cor#orati! the a0erae e!ame& %)&e a!&e to ")##ort the thic5 i!i0a1
I! "ome ca"e" e0e! the -e!ta& *&o"" i" i!ca#a%&e o* remo0i! #&a;)e *rom
the co!ca0e ")r*ace", "o arti*icia& cro/! co!to)r" a!- "o&-er 8oi!t" are create- to
accommo-ate the #a""ae o* *&o"", other/i"e i!i0iti" or #erio-o!titi" ma$ re")&t
%eca)"e o* the i!a%i&it$ to c&ea!1
20 Cast a#5ustments:
The"e are )")a&&$ -o!e /ith r)%%er$ "to!e" i!creme!ta&&$ remo0i! ca"t
materia& ")r*ace /i"e to o%tai! the e,act -ime!"io!", co!*i)ratio! a!-
i!terre&atio!"hi# o* the co!tact a!- co!to)r1 It i" #art&$ -o!e o! the /or5i!
mo-e&" a!- #art&$ or *i!a&&$ i!traora&&$1
CONC*USION:
Pro#er re#ro-)ctio! o* the "iBe a!- &ocatio! o* the co!tact area" to imitate
the !at)ra& -e!titio! i" e""e!tia& *or the ")cce"" o* treatme!t a!- the re"toratio! o*
#ro,ima& ")r*ace1 The hea&th o* the #erio-o!ta& ti"")e" i" -e#e!-e!t o! #ro#er&$
-e"i!e- re"toratio!"1 O0erha!i! re"toratio!" a!- o#e! i!ter#ro,ima& co!tact"
"ho)&- %e a--re""e- a!- reme-ie- -)ri! the -i"ea"e co!tro& #ha"e o* #erio-o!ta&
thera#$1
''
RE)ERENCES:
De!ta& A!atom$, Ph$"io&o$, Occ&)"io! < Chee&erF"1 @
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Art a!- Scie!ce o* O#erati0e De!ti"tr$ < St)r-e0a!t1 .
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O#erati0e De!ti"tr$ < Mo-er! Theor$ a!- Practice < M1A1 MarBo)51 2
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A Te,t Boo5 o* O#erati0e De!ti"tr$ < McGhree1 .
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A-0a!ce- O#erati0e De!ti"tr$ < Baratieri1 '
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Te,t Boo5 o* O#erati0e De!ti"tr$ < 9ima& N1 Si5ri1 2
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O#erati0e De!ti"tr$ < Gi&&more1 .
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F)!-ame!ta&" o* Fi,e- Pro"tho-o!tic" < Shi&&!%)rPP1 4
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Theor$ a!- Practice o* Fi,e- Pro"tho-o!tic" < T$&ma!1 G
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