Sectional matrix system in reconstruction of proximal contact in class ii resin restoration

Background: Clinicians always faces some challenges to reconstruct proper proximal contact while restoring class-II cavity with composite resin due to its viscosity, elastic property and polymerization shrinkage. It has been claimed that use of sectional pre-contoured matrix band with separation ring will produce more reliable result for reconstruction of optimal proximal contact in class II composite resin restoration. Purpose: To evaluate the efficacy of sectional pre-contoured matrix band with separation ring for reconstruction of optimal proximal contact in class II resin composite restoration. Methodology: One Nissin manikin model having the facility of placing and screwing all upper and lower sets of artificial human teeth and sixty-two (62) artificial human mandibular permanent 1st molar teeth were collected. These 62 artificial human mandibular permanent 1st molars were randomly assigned in two groups (A & B) having 31 teeth in each. Standardized class II MO (mesio-occlusal) cavity were prepared on total 31 artificial 1st molar in group A. The 2nd premolar in the manikin model was replaced by metal cast duplicate and permanently fixed into the socket. All the Thirty-one (31) 1st molar teeth in group A, having Prepared class II cavity in each, were replaced one by another in the manikin distal to cast duplicated 2nd premolar and restored with composite resin by using sectional pre-contoured matrix band with separation ring and another 31 uninstrumented intact artificial 1st molars were include in group B as a reference group. After completion of restoration, newly developed proximal contact points were measured by using universal testing machine one after another. Same were also done in intact reference Group B. Measurement was done to assess the position of contact point, contact tightness and contact area of Group A and Group B on the same typodont. The results were analyzed statistically with post hoc Bonferroni test (P<0.05). Result: Teeth restored with sectional pre-contoured matrix with separation ring (group A) provided the tighter contact and broadened area of contact where all the contact points were placed more occlusally compared to that of the intact un-instrumented reference teeth (group B).Statistically significant differences (P<0.05) were produced in all the three parameters with each other. Conclusion: Teeth restored with sectional pre-contoured matrix band with separation ring failed to reconstruct the optimal proximal contact in class-II composite resin restoration in comparison to intact uninstrumented reference tooth. Update Dent. Coll. j: 2021; 11(2): 16-19

Customized Coronal Conformation Systems for Lateral Teeth’s Direct Restorations

The restoration of a proximal wall depends on several factors, the conformation system playing one of the most important parts of the working protocol. The vertical, transversal and sagittal adaptation of the matrix band implies the use of one or two wedges and of a sectional matrix device (usually with a ring shape) with tines. The size, configuration and the material the tines are made of determine most of the quality of the adaption and stabilization of the matrix band. Even if these standardized tines have various designs and variable flexibility, a truly efficient tine should have a customized configuration which can be obtained after taking the impression of the initial proximal wall. The clinical situations that allow the customization of the standard tines imply proximal caries that have not interrupted the proximal wall or that have interrupted it less than one third of the transversal distance.

Use of a Modified Matrix Band Technique to Restore Subgingival Root Caries

SUMMARY Given the increasing incidence of root caries in the elderly population, clinicians frequently must isolate and restore subgingival preparations. This article demonstrates a technique utilizing a modified Tofflemire matrix band that creates a preparation free of crevicular fluid and blood for restoration with resin-modified glass ionomer cement.

Comparison of Proximal Contact and Contours of Premolars restored with Composite Restoration using Circumferential Matrix Band with and without Separation Ring: A Randomized Clinical Trial

ABSTRACT Aim To compare the proximal contacts and contours in class II composite restorations in premolars achieved with Automatrix band with separation ring vs Automatrix band alone. Materials and methods A total of 188 premolar teeth with proximal cavity were assigned on alternate basis in two groups. Intervention group teeth received Automatrix band with separation ring using clamp forceps, while the control group received Automatrix band alone. All preparations were restored with P-60 composite (3M-ESPE Dental, USA). The outcome (proximal tightness) was determined by a blinded assessor. Chi-square test was applied to compare the contact tightness between the two groups. Spearman's rank correlation coefficient was applied to determine any correlation between the contact tightness with proximal contours. p-value of 0.05 was taken as significant. Results The intervention group exhibited better proximal contacts than the control group (p-value 0.040). There was no correlation between the contact tightness and the proximal contours. Conclusion The use of separation ring along with Automatrix matrix band in class II composite restorations resulted in significantly better proximal contacts than Automatrix band alone. However, the separation ring does not contribute in producing an additional improvement in the proximal contours. The proximal contour has no relationship with the proximal contact tightness. Clinical significance Several techniques have been advocated to get tight contacts in composites including interdental separation ring. Our study focuses on using separation ring with circumferential matrix band instead of a sectional band. Moreover, we have attempted to study proximal tightness and proximal contours of composite restoration as separate variables. How to cite this article Khan FR, Umer F, Rahman M. Comparison of Proximal Contact and Contours of Premolars restored with Composite Restoration using Circumferential Matrix Band with and without Separation Ring: A Randomized Clinical Trial. Int J Prosthodont Restor Dent 2013;3(1):7-13.

Keberhasilan Restorasi Komposit untuk Perbaikan Titik Kontak pada Terapi Periodontal

Latar Belakang: Pada kondisi fisiologis, gigi geligi berada pada posisi stabil dalam lengkung rahang, mempunyai kontak oklusal dengan gigi lawan, dan kontak proksimal dengan gigi disebelahnya. Adanya sedikit pembukaan kontak proksimal akan menyebabbkan terjadinya impaksi makanan, yang merupakan etiologi kelainan periodontal. Pembuatan restorasi permanen dengan menggunakan bahan komposit yang memperhatikan kontak proksimal, kontur permukaan oklusal, kontur fasial dan lingual dapat melindungi jaringan periodontal. Tujuan: menunjukkan bahwa restorasi komposit untuk perbaikan titik kontak dapat menunjang kesehatan jaringan periodontal. Laporan kusus: pada kasusu pertama ditemukan gigi 2.4 dan 3.5 terdapat karies di sisi distal, dan pada kasus kedua gigi 2.8 terdapat karies di sisi mesial sehingga kehilangan titik kontak yang mengakibatkan terjadi poket periodontal. Penanganan: terapi awal yang dilakukan berupa skeling dan penghalusan akar, serta kuretase. Pembuatan restorasi komposit untuk memperbaiki titi kontak dengan menggunakan matriks dan baji di area proksimal. Maladaptasi pita matriks atau baji menyebabkan kegagalan klinis seperti batas restorasi mengemper, kontur didnding proksimal serta titik kontak yang tidak baik. Pemilihan baji yang benar, harus mempertimbangkan : sudut konvergensi dasar, lebar mesiodistal dasar baji, ketinggian gingivooklusa dari arah transversal, dan kecembungan dinding baji. Kesimpulan: secara klinis terjadi penurunan kedalaman poket setelah perbaikan restorasi, namun gambaran radiografis belum memperlihatkan hasil signifikan dalam waktu tiga bulan. Blackground: under physiological conditions, teeth are stabilized in the dental arch by making occlusal contacts with opposing teeth and proximal contacts with adjacent teeth. A weak or slightly open proximal tooth contact would permit food impaction, one of the etiology of periodontal disease. The common therapy is to make a permanent restoration using composite restoratioan having regard to proximal contacts, occlusal contour, and facial and lingual contaour to protect periodontal tissues. Objective: to show that it is important to restore contacts points in maintaining periodontal tissues using composite restoration. Case: on the first case, we found caries on the distal site of 2.4 and 3.5 and mesial site of 2.8 on the second case, and open contacts, resulting a periodontal pocket. Therapy: the initial treatment are scaling and root planning and curretage. Composite restoration to restore proximal contact points using matrix band and wedge. Maladaptation of either the matrix band or the wedge result in clinical failure such as overhanging margins, faulty contouring of the proximal wall and inadequate contact points. To select a correct wedge, four variables should lie considered the convergence angle of the base, the mesiodistal width of the base, the gingivo-occlusal height of the transverse section and the concavity of the side walls. Conclusion: Clinically, there are reduction in pocket depth after the restoration, but radiograpgically, there are no significant result in three months.

Proximal Contact Tightness Between Direct-composite Additions in the Posterior Dentition: An In Vitro Investigation

SUMMARY Purpose The aim of the study was to test whether a novel three-step matrix technique for posterior direct-composite additions creates sufficiently strong proximal contacts. Materials and Methods Contact tightness was measured between direct-composite additions and between original teeth on a model. Therefore, the frictional forces required to remove a straight, 0.05-mm-thick, metal matrix band inserted between adjacent teeth and held by a universal testing machine (Zwicki, Zwick GmbH, Ulm, Germany) were recorded. Measurements were taken at three time points to carry out reference analysis: at baseline, after removal of the maxillary right second premolar (tooth #15) to simulate a diastema, and after closure of the diastema by inserting two direct-composite additions with the three-step matrix technique on the maxillary right first premolar (tooth #14) and first molar (tooth #16). Measurements were performed in the maxillary right (first) and left (second) quadrants to document sagittal displacement. Results The original contact tightness values were between 1.65 ± 0.88 N and 3.05 ± 0.60 N in the first quadrant and between 1.23 ± 0.51 N and 2.18 ± 0.43 N in the second quadrant. After removal of tooth 15, values decreased significantly in the first quadrant and insignificantly in the second. After reconstruction, the contact tightness between teeth 14 and 16 was significantly stronger (tighter) (3.20 ± 0.80 N) than the originally measured contact tightness between teeth 14 and 15 (2.86 ± 0.64 N) and teeth 15 and 16 (1.65 ± 0.88 N) (p=0.006 and 0.001, respectively). Conclusions Within the limitations of an in vitro investigation, this study has shown that by using a novel, three-step matrix technique, direct posterior composite additions can form sufficiently tight proximal contacts.

Modified Matrix Band Design for Ultra-conservative Posterior Restorations

Clinical Relevance The combination of minimally invasive cavity preparations and adhesive restorations allows clinicians a significantly more conservative approach to proximal carious lesions of teeth adjacent to MO/DO preparations.