Poor occlusal anatomy/contacts (high points / flat anatomy)
What it is
After placing a posterior restoration (especially composite), the occlusion is left with either: 1) High points / premature contacts (restoration "high" in centric and/or excursions) → can cause pain on biting, chewing discomfort, and patient complaints that often improve after occlusal adjustment. 2) Flat/incorrect anatomy (lost cusps, shallow fossae, incorrect marginal ridge height) → poor chewing efficiency, food trapping, and increased risk of wear or needing major adjustment.
Why it happens
• No structured occlusal check after finishing (centric + excursions), or checking only lightly with thin paper. • Overbuilding anatomy (too much composite, especially in occlusal increment) or leaving a "flash" of composite that becomes the high spot. • Not respecting occlusal height relationships (cusp tips, marginal ridges, main sulcus, pits/fossae) → anatomy becomes unbalanced and requires excessive grinding, often ending flat. • Skipping morphology guidance tools (pre-op occlusal map/photos, stamp index) that help reproduce original anatomy in posterior composites.
The full clinical mistake entry includes
- How to avoid it — the prevention protocol
- The clinical tip experienced clinicians use
- The documented reference behind the mistake
More clinical mistakes
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