Undesirable tooth anatomy, position or large gap
Dentists frequently have to deal with non-ideal occlusions as many patients have unresolved or untreated orthodontic problems. Teeth can be rotated, tilted, out of the arch line and inter-proximal gaps can occur. Flexibility and ingenuity are required to solve these tricky cases. The Rhondium QuickConnect Anatomy band lends itself to these tricky cases as it has good contours and the tabs can be secured to close large inter-proximal gaps.
Narrow contact point when wider contact is desirable
Premolars tend to have narrow contact points while molars have broader contacts. As mentioned above, the “push the contact” method generally produces narrow contacts and it is difficult, if not impossible, to obtain broad contacts with this method, especially when the cavity is small. The tabbed version of the QuickConnect Anatomy Band enables a clinician to obtain broader contacts in two ways;
- Before curing, the tab that is in the best position is pulled towards the adjacent tooth while light-curing. The harder the tab is pulled, the broader the contact.
- If necessary, the tab can be temporarily bonded to the occlusal surface of the adjacent tooth. After applying bond and flowable, one of the tabs is pulled firmly while the flowable is cured. If this does not produce enough width, a second tab can also be secured in the same way and this produces a very satisfactory outcome.
Rhondium has a sectional matrix called the Sure Matrix that is fully contoured and has a longer tab with multiple holes that is ideal for the above two techniques.
Matrix foil too thick
Matrix bands with a thickness of greater than 50 microns are available, particularly Mylar bands which are often 60 microns. This are not recommended as it can be difficult to separate the teeth enough to compensate for the band thickness.
The key to avoiding poor contact anatomy and tightness lies in selecting the best designed matrix bands and using the techniques covered above.
The most common unrecognised cause is that the matrix band pulls away from the adjacent proximal tooth surface without the clinician realising, as the matrices or separator rings obscure the inter-proximal space.
Contoured circumferential retainer-less matrix bands can provide many benefits for achieving proper proximal contact in large restorations and sectional matrices work well for small restorations. By using the appropriate technique and the best designed matrix bands, dentists can achieve successful and long-lasting restorations.
Conflicts of Interest
Dr Simon McDonald is a shareholder of the Rhondium company and joint inventor of the QuickConnect Anatomy Band.
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