Moisture control

Today I placed a large 12MIDL composite resin without rubber dam. Not sure about my reasoning about the lack of rubber dam but it would have been difficult to place due to the subgingival nature of the prep. This is not an excuse however and the patient's inflamed gingiva kept bleeding onto the composite resin. Long term, this increases the risk of staining and secondary caries. I placed a retraction cord but didn't place it interproximally. Instead i placed it flowing onto the gingival margin of the adjacent teeth. I think that the lack of cord in the interproximal allowed bleeding onto the composite resin. If I could restore this tooth again, I would pack cord or teflon tape then rubber dam from premolar to premolar and use floss ties to invert the dam into the sulcus +/- an anterior cord.

Also, the contralateral lateral incisor was missing which made it difficult to form anatomy till symmetry. Additionally the ipsilateral canine was buccally and labially positioned. A contact point was present but the distoincisal corner was far away from the canine which gave the lateral incisor a strange appearance.