Space Closure with Composite Fillings and Modified Crown

Patient’s chief complaint was food stagnation in an upper canine-premolar area and history of changing a crown on 1st premolar twice due to the same problem. On examination, the patient was found to have a grossly cut 2nd premolar with uncontoured amalgam filling, overcontoured crown on 1st premolar with open margins and class iii cavity in canine. Treatment was planned on 3 steps. It commenced with replacing amalgam filling with a well-contoured composite resin on 2nd premolar. Then, large class iii cavity in the canine was filled with A3 body composite with light brown staining (ENA HRi). The tooth was slightly overfilled to reduce the space between the canine and 1st premolar to prevent food retention in this area. On the last step, old underlying class ii amalgam filling in 1st premolar was substituted with composite, the tooth was prepared for a crown, but some surrounding gum inflammation was noticed. After complete gum healing, the crown on 1st premolar was replaced with a new crown with increased mesio-distal width, also to stop food stuck in this area.