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Dr Jamal NaimDean of the faculty of dentistryUniversity of Palestine/Al-Zahra City
Class II Restorations
Bite Wing X-ray
MO, OD, MOD
Restorative techniques There are several different restorative
techniques available to the clinician. We will discuss two options.
Amalgam Filling Composite Filling
Gaining Access
Depth
Outline
Proximal Caries
Outline
Bur # 330
Clean DEJ and remove infected dentine. Size of bur determined by extent of caries
Caries removal
Proximal Box Preparation
Preparation of gingival seat, buccal and lingual walls and axial wall of the proximal box
Adjacent tooth protection with matrix band
Proximal Box Preparation
Extent buccal and lingual walls of proximal Box so margins lie into self cleansing areas
Proximal Box Preparation
Don’t leave unsupported enamel Gingival seat parallel to occlusal surface
Proximal Box Preparation
Proximal Box Preparation
Line dentin with adequate base material (zinc phosphate cement or GIC)
Caries removal
Matrix Band
Apply matrix band Apply wedge from palatal side Burnish contact area
Review cavity
The cavity must be checked for the followings before manipulation of amalgam
Adequate self-retention. Proper resistance. CSA 90. No caries, debris or moisture. Pulp is protected with cavity varnish, linear or
base material depending on the cavity depth. Proper matrix is fitted.
Restoration
Transfer amalgam to cavity in increments Start with proximal box
Restoration
Condense amalgam thoroughly Use largest possible plugger
Restoration
Overfill the cavity Separate amalgam from the matrix with a probe
Restoration
Carve with half hollenbach carver Carve from tooth to filing following the margins Don’t over carve
Matrix removal
Matrix removal
Remove the wedge Remove band first distal then mesial
The gingival margin is then checked for any over hanged margin of amalgam using sharp probe and also carving of the gingival embrasure if needed.
Finishing
Complete carving Burnish all possible areas
Finishing The patient is then instructed not to use this side for
the next 24 hours to avoid cracking or fracturing of the restoration.
Also the patient should be advised to come after 24 hours for finishing and polishing of amalgam.
Why?After 24 hours of carving to avoid
disturbing crystallization of amalgam.
Finishing and polishingFinishing and polishing Aims:
1. Removal of any premature contact, marginal flashes or marginal over hangs.
2. Provide a lustrous homogenous amalgam surface.
Advantages:
1. Increases corrosion resistance.
2. Decreases bacterial plaque retention and liability to recurrent caries.
3. Minimizes gingival irritation.
4. Improves strength of amalgam, as it removes the surface irregularities that act as stress concentration areas.
Finishing and polishingFinishing and polishing
Technique:
Finishing:
1. Using finishing bur in a direction
from the tooth to restoration.
2. Using sandpaper discs for
accessible surface.
Finishing and polishingFinishing and polishing
Technique:
Polishing:
1. Using pumice with brush or rubber
cup.
2. Avoid heat generation, as it will
lead to attraction of Hg to the
surface resulting in:
a) Weakening of the surface.
b) Weakening of the bulk due to the
formed porosity.
Matrix Bands
Matrix: That which contains and gives shape and form to anything.
Dental matrix: A piece of metal or non-metal, which gives form
and support to the restoration during packing and hardening.
Used only with direct restorative materials, which are packed into the cavity in the plastic form.
Matrix Bands
Tofflemire Matrix band
Tofflemire Matrix band
Function of matrix Serves as temporary wall or walls during
condensation of plastic materials packed into compound or complex cavities.
Gives form and shape to the restoration especially in contact area.
Maintains this form of the restoration until it hardens.
Prevents gingival marginal overhangs.
The matrix band should be properly supported with a wedge to provide adaptation of the band on the gingival floor and prevents marginal overhangs.
Wooden wedges
The cavity should be properly matriced and wedged before manipulation of amalgam.
Management of Matrix band
Management of Matrix band
Management of Matrix band
Management of Matrix band
Management of Matrix band
Management of Matrix band
Matrix band application
Matrix band application
Matrix band application
Matrix band removal
Matrix band removal
Hawe Matrix
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