Subgingival Restoration Access — ORE Part 1 MCQ

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ModerateRestorative DentistrySubgingival Restoration AccessORE Part 1

A patient requires a composite restoration for a Class V cavity on the buccal surface of the lower right first premolar. The cervical cavity margin lies 2 mm below the gingival margin. Which measure would most directly improve moisture control at the cervical margin?

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Correct answer: A — Place retraction cord in the gingival sulcus

**Answer: A.** A subgingival cervical margin is vulnerable to contamination by gingival crevicular fluid and bleeding. Retraction cord placed in the sulcus displaces the marginal gingiva and assists control of sulcular fluid, improving access and moisture control directly at the margin before composite bonding. The cited clinical literature specifically identifies sulcular exposure and control of haemorrhage/crevicular-fluid seepage as prerequisites when treating cervical lesions. A rubber dam is generally an excellent isolation method, but a conventional winged clamp alone does not necessarily expose a margin 2 mm below the gingiva; adjunctive retraction may still be needed. Cotton rolls provide limited saliva control but cannot displace marginal gingiva. Lip retraction does not control saliva or sulcular moisture, and proceeding without isolation risks contamination of the adhesive interface.

Reference: Fazekas A, Csempesz F, Csabai Zs, Vág J. Effects of pre-soaked retraction cords on the microcirculation of the human gingival margin. Operative Dentistry. 2002;27(4):343-348. https://pubmed.ncbi.nlm.nih.gov/12120770/