6/22/2017 MatrixPlacementforClassIIAmalgamRestoration

MatrixBandPlacement
(seealsoSturdevant,4thed.,pg.718726)

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TheUniversal(Tofflemire)matrixsystemisusedinClassIIrestorations.Theprimaryfunctionofthematrixis
torestoreanatomicproximalcontoursandcontactareas.Aproperlyplacedmatrixshould:

Berigidagainsttheexistingtoothstructure
Establishproperanatomiccontour
Restorecorrectproximalcontactrelation
Preventgingivaloverhang
Beabletobeeasilyremoved

Armamentarium
TofflemireMatrixRetainer
Matrixbands
(narroworwideusagedependsondepthofgingivalcavosurfacemargin)
Wedges
CottonPliers
Scissors
Knife

MatrixRetainerVideoDemo

Thematrixretainerhasfourparts:

1.HeadUshaped,hasthreeguides,orslots,forthe
positionoftheband
2.Lockingviseslidingbodythatholdstheband
3.Longknobchangesthediameteroftheloop
4.Shortknoblocksthebandinplacewithinthe
slidingbody

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Procedure
1.Trythewedge.
2.Burnishthematrixband.

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3.Placethematrixbandintotheretainer.
4.Fitthematrixontothetooth.
5.Placethewedge.
6.Tightenthematrixbandaroundthetooth.

Trythewedge.

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Useofawedgewiththematrixbandservestwopurposes:

1.Helpstocompressthematrixbandagainstthetoothstructuretocreateatighterseal,preventinggingival
overhang.
2.Providesslightseparationbetweentheteeth,compensatingforthethicknessofthematrixband,andthus
helpingtocreateatightcontactbetweenthefinishedrestorationandtheadjacenttooth(otherwise,when
matrixbandisremoved,aspaceequalingthethicknessofthematrixbandwouldexistbetweenthe
restoredproximalsurfaceandtheadjacenttooth).

Priortoplacingthematrixband,placeawedgeinthegingivalembrasuretochecktherelationshipbetweenthe
occlusalsurfaceofthewedgeandthegingivalcavosurfacemargin.Inorderforawedgetobeeffectiveduring
amalgamplacement,itshouldfittightlyagainstthetoothanditsocclusalsurfaceshouldextendabovethe
gingivalcavosurfacemargin,creatingatightseal.

Toplacethewedge,stretchtherubberdamtightlytoallowittoseatmoregingivallyandkeepitfromgetting
caughtbythewedge.Afterplacingthewedge,usethebluntendofthecottonplierstopushitintoplace.

Ifthewedgefitstightlyagainstonlyaportionofthegingivalproximalsurface,fitaslightlylargerwedgeand
useaknifetocontourthesideofthewedgefacingtheproximalsurface,sothatitfitssnuglyaroundtheentire
gingivalproximalsurface.Forexample,thiscontouringofthewedgeisoftenrequiredwhenrestoringthemesial
surfaceofthemaxillaryfirstpremolar,duetothemesialconcavitythatexistsinitscervicalportion.

Ifthewedgefitstightlyagainstthetoothbutitsocclusalsurfaceistoohighabovethegingivalcavosurface
margin,aknifecanagainbeusedthetrimtheocclusalsurfaceofthewedgesothatitextendsjustabovethe
gingivalcavosurfacemargin.

Fig.1785:Modifiedtriangular

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6/22/2017 MatrixPlacementforClassIIAmalgamRestoration
(i.e.,anatomic)wedge.A,
Dependingonproximal
convexity,triangularwedge
maydistortmatrixcontour.B,
Asharpbladedinstrumentmay
beusedtomodifythetriangular
steepnessofthewedge.C,
Modifiedandunmodified
wedgescompared.D,Properly
modifiedtriangularwedge
preventsdistortionofmatrix
contour.

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Burnishthematrixband.

Theflatmatrixbandmustbeburnished,orshaped,toachieveacontourfacilitatingitsproperadaptationtothe
toothstructure.Beginbyfoldingapapertowelseveraltimesandplacingitonthebenchtopthisprovidesa
morecushionedsurfaceforburnishing.Holdthematrixbandinplaceonthepapertowelanduseaburnisheror
thebluntendofaninstrument,suchasanexaminationmirror,torubagainstmatrixbandbackandforth.This
willintroduceacurvatureintothematrixband.

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6/22/2017 MatrixPlacementforClassIIAmalgamRestoration

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Placethematrixbandintotheretainer.

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Topreparetheretainertoreceivetheband,turnthelongknobtomovethelockingviseallthewaydowntothe
headoftheretainer.Thenturntheshortknobtoloosentheretainingscrew(theretainingscrewshoulddisengage
fromtheslidingbody).

Foldthebandtoformaloopnoticethatwhenthebandisfolded,oneedgehasasmallercircumferencethanthe
otherthisdesignaccomodatesthedifferenceintoothcircumferencesatthecontactandgingivallevels.There
aretwomainrulesforcorrectplacementofthematrixsystemonthetooth:

1.OpenendoftheretainerheadisALWAYSplacedtowardthegingiva.
2.Smallercircumferenceofthebandisalwaysplacedtowardthegingiva.

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Basedonthetworulesabove,thefollowingisalsotrue:

Theocclusaledgeofthematrixbandmustbeplacedintheretainerwiththeocclusaledgefacingthe
retainer.
IntheLRQ&ULQ,thescrewsideofretainerisfacesthebuccalsurfaceofthetoothintheURQ&LLQ,
theflatsideoftheretainerfacesthebuccalsurfaceofthetooth.

Theserulesserveasaguidetohowthematrixbandmustbepositionedintheretainer.Withtherulesinmind,
placethetwoendsofthebandintheslotofthelockingvise(occlusaledgeofthebandfacingtheretainer)and
positionthebandinthecorrectslotofthehead,suchthattherulesabovewillbesatisfied.Turnthesmallknob
clockwise,loweringthescrewintotheviseandthuslockingthematrixbandwithintheretainer.

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Fitthematrixontothetooth.
Thebandshouldbeseatedaroundthetoothsuchthat:
1.Theocclusalportionofthebandextends1.52.0mmabovethemarginalridgeoftheadjacenttoothandthe
cavosurfacemarginthisallowsforpropercondensationoftheamalgaminthemarginalridgearea.
2.Thegingivalportionofthebandextends0.5mmbelowthegingivalCSM.

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6/22/2017 MatrixPlacementforClassIIAmalgamRestoration

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Incertainsituations,itmaybedifficulttoachieve
theproperfitinthegingivalarea,suchaswhena
gingivallylocatedcariouslesionnecessitates
gingivaloverextensionofthecavosurfacemargin.
Insuchsituations,whilethebandmayfitcorrectly
ontheaffectedside,properfitaroundthe
unaffectedproximalsurface(eg.,inaDOprep,the
mesialtoothsurfacemaybyimpededbythe
interdentalpapilla.Tofacilitateproperfittingofthe
matrix,itmaybenecessarytotrimthematrixband
attheunaffectedproximalsurface.Besureto
alwaystrimthegingival,ratherthantheocclusal
portionofthematrixband.

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Tightenthematrixbandaroundthetooth.
Totightenthematrixbandaroundthetooth,turnthelongknobthiswillpullthematrixbandupalongwiththe
slidingbody,thusdecreasingthediameterofthematrixbandandtighteningitaroundthetooth.Tightenthe
matrixasmuchaspossiblearoundthetooththisallowsforproperamalgamcondensationandcontour
development.

Tocheckthattheexploreristightlyadaptedtothegingivalsurface,useanexplorerandtryashardaspossibleto
placethetipbetweenthematrixbandandthegingivalcavosurfacemarginyoushouldnotbeabletodoso.This
alsohelpstoremoveanyunsupportedenamelleftinthearea.

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Placethewedge,onceitisseatedtightlyinthegingivalembrasure,loosenthematrixbandslightlybyturning
theknob1/4ofaturn.Thispreventsthematrixbandfrombeingtootight,whichmayleadtoanopencontact
andmayhinderpropercondensationoftheamalgamintotheproximalcavosurfacemarginareas

Finally,useaspoonexcavatororburnishertoburnishthematrixbandtotheadjacentproximalcontactarea.

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