I have found when I don’t want to break contact in a Class 2 preparation, to preserve tight contact with final restoration, I need to place a thin Tofflemire matrix before I prep. This way I don’t have to break contact to get a thin matrix band on the tooth thereby allowing me to get a tight contact with the neighboring tooth. After I prepare the tooth I then will add a wedge and a ring before restoring to ensure a tight contact. At this point I burnish the matrix and fill with composite and light cure. I know I have seen something similar to this on DentalTown.com, but here is my twist. Also I am not suggesting replacing all the new matrix systems but just thought I would give a tip that’s helped me.


Conclusion
Note it is incipient decay and with her high caries index and poor oral hygiene I thought it was best to intervene at this stage.
Patient always got canker sores after dental visits but we thought it might be do to a latex allergy and used vinyl gloves. Patient reported no canker sores after the visit for the first time she can remember.
Dr. Whelan is a graduate of the University of Southern California School of Dentistry. He is a member of the Mid-America Orthodontic Society, the Dental Organization for Conscious Sedation, and the American Board of Family Dentistry. Dr. Whelan maintains a thriving laser and cosmetic practice in Irvine, California.
Townie Comments
doctored | Posted 3/3/2004 12:21 am |
Hello Ken, I think you did a great service keeping the preparation to a minimum. Do you still use an incremental placement technique on these conservative preparations? |
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kenw | Posted 3/3/2004 12:36 am |
I still place a layer of flowable at floor box then light cure, then place packable 3M Filtek P60 composite to fill rest. |
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davetherave | Posted 3/3/2004 6:40 pm |
Great idea. What do you do if you cut the band while prepping? |
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kenw | Posted 3/3/2004 10:29 pm |
Hi Dave, I use a small burr, a 699 or 701 burr and have not stripped a matrix yet. If you did you most likely would not be able to do this procedure. |
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docwatson | Posted 3/3/2004 10:52 pm |
Have you used the Palodent matrixes? They are nice because when you have only one contact to restore, they fit through only one contact instead of having a Tofflemire type band around the entire tooth. They are precurved as well so I create better occluso-gingival roundness where sometimes a Tofflemire band makes a flatter wall. I have found sometimes with a Tofflemire band that the contact will be tight but the proximal wall will be flat. Back to the Palodent bands...the ring really holds them in place as well. I have found that if I place a good wedge, have a tight ring in the embrasures and even burnish the band against the adjacent tooth wall, contacts are just not a problem. |
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kenw | Posted 3/3/2004 11:21 pm |
Hi Docwatson, I use Palodent as well but in my hands if I have not completely broken contact I cannot get matrix in or just destroy it miserably. Otherwise, like you say it’s a great system and I use it if I have broken contacts all the way through. |
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