4. SIZE & SHAPE
SIZE:- 12 inches
(1.2CM)
Wedges are
available in various
sizes, which may be
color coded. They
are either plain
(straight) or
anatomically
(triangular) shaped.
5. Wedges come in
many sizes and
shapes and can be
customized for
almost any situation.
If the proper size
can not be
found, they can be
modified to fit the
interproximal area
by cutting the wood
away.
6. MODE OF INSERTION
Break off approximately inch of
a round toothpick. Grasp the
broken end of the wedge with
the no. 110 pliers. The wedge is
generally placed on the
lingual, away from the side of
the tooth on which the retainer
is located. The lingual
embrasure is also usually the
widest of the two
embrasures, and therefore is
often in greater need of the
adaptation of the band by the
wedge.
7. POSITION & PLACEMENT
A wedge should be positioned as near to the gingival
cavosurface margin as possible without being occlusal to it.
If necessary, the gingival aspect of the wedge may be
lightly wetted with lubricant to facilitate its placement.
The wedge not only stabilizes the matrix but more
importantly it is placed below the gingival cavosurface
margin to prevent amalgam from flowing beyond the
cavosurface margin in that area. This area is the most
inaccessible area for carving instruments, therefore it is
critical to place a wedge that will prevent excess amalgam
flowing beyond the gingival margin and forming overhangs.
8. If the wedge is placed occlusal to the gingival margin, the band will
be pressed into the preparation, creating an abnormal concavity in
the proximal surface of the restoration. The wedge should not be so
far apical to the gingival margin that the band will not be held tightly
against the gingival margin. This improper wedge placement will
result in gingival excess caused by the band moving slightly away
from the margin during condensation of the amalgam. Such an
overhang often goes undetected and may result in irritation of the
gingival or an area of plaque accumulation.
Correct
Correct & Incorrect wedge position
9. PIGGY BACK WEDGE
If the wedge is
significantly apical of the
gingival margin, a second
(usually smaller) wedge may
be placed on top of the
first to wedge adequately
the matrix against the
margin.
This type of wedging is
particularly useful for
patients whose
interproximal tissue level
has receded.
10. TIGHTNESS
The gingival wedge should be tight enough to prevent
any possibility of an overhang of amalgam in at least
the middle two third of the gingival margin.
11. DOUBLE WEDGING
Indication:-
Double wedging
is permitted
(if access allows,)
securing the
matrix when the
proximal box is
wide faciolingually.
12. Procedure:-
Double wedging refers to using two wedges: one from
the lingual embrasure and one from facial embrasure.
Two wedges help to ensure that the gingival corner
of the wide proximal box can be properly
condensed,they also help to minimize gingival excess.
However double wedging should be used only if the
middle two third of the proximal margin can be
adequately wedged.
Because of the facial and lingual corner are
accessible to carving proper wedging is important to
prevent gingival excess of amalgam in the middle two
third of the proximal box.
13. WEDGE WEDGING:-
Occasionally concavity may
be present on the proximal
surface that is apparent in
the gingival margin. This
may occur on a surface with
a fluted root such as the
mesial surface of the
maxillary 1st premolar.
14. A gingival margin located in
this area may be concave. To
wedge a matrix band tightly
against such a margin a
second pointed wedge can
be inserted between the 1st
wedge and the band. This is
referred as wedge wedging
The wedging action between
the teeth should provide
enough separation to
compensate for the
thickness of the matrix
band. This will ensure a
positive contact relationship
after the matrix is removed
15. TEST FOR TIGHTNESS OF THE WEDGE
Test for tightness of the wedge by
pressing the tip of an explorer
firmly at the several point along the
middle two thirds of the gingival
margin (against the matrix band) to
verify that it can not be move away
from the gingival margin. As an
additional test, attempt to remove
the wedge (using the explorer with
moderate pressure) after first
having set the explorer tip into the
wood near the broken end.
Moderate pulling should not cause
dislodgement.
16. Use explorer tip (with pressure) to ensure proper
adaptation of band to gingival margin. Press and
drag the tip of the explorer along the gingival
margin in both directions to ensure to removal of
any remaining friable enamel.
17. TRIANGULAR (ANATOMIC) WEDGE
The triangular (i.e., anatomic)
wedge is recommended for a
preparation with a deep gingival
margin.
The triangular wedge is usually
indicated with the tofflemire MOD
matrix band.
The triangular wedge is positioned
similarly to the round wedge, and
the goal is the same.
18. When the gingival margin is
deep (cervically) the base of
the triangular wedge will more
readily engage the tooth
gingival to the margin without
causing excessive soft tissue
displacement.
The anatomic wedge is
preferred for deeply
extended gingival margins
because its greatest cross-
sectional dimension is at its
base.
19. CUSTOM MADE TONNGUE BLADE WEDGE
A suitably trimmed tongue blade
can wedge a matrix where the
interproximal spacing between
teeth is large.
Occasionally, however, it is
impossible to use a wedge to secure
the matrix band . In this case, the
band must be sufficiently tight to
minimize the gingival excess of
amalgam. Because the band is not
wedged, special care must be
exercised by placing small amounts
of amalgam in the gingival floor and
condensing the first 1 mm of
amalgam lightly, but thoroughly, in a
gingival direction.
20. SUPPORT WITH HOLLENBACK CARVER BLADE
Supporting the matrix material
with the blade of a Hollenbeck
carver during the insertion of
the wedge for the difficult deep
gingival restoration may be
helpful. The tip of the blade is
placed between the matrix and
gingival margin and then the
“heel” of the blade is leaned
against the matrix and adjacent
tooth.
In this position the blade
supports the matrix to help
both in positioning the wedge
sufficiently gingivally and
preventing the wedge from
pushing the matrix into the
preparation. After the wedge is
properly inserted, the blade is
gently removed.
