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Matrices in Operative DentistryMatrices in Operative Dentistry
22
Matrix ?Matrix ?
A matrix is defined as a properlyA matrix is defined as a properly
contoured piece of metal or otherco...
33
IntroductionIntroduction
 Unfortunately, dentistry does not have a trulyUnfortunately, dentistry does not have a truly...
44
Why do we need matrices ?Why do we need matrices ?
 Gingival floor of a class IIGingival floor of a class II
cavity is...
55
Characteristics of a good matrixCharacteristics of a good matrix
 Rigidity.Rigidity.
 Establishment of proper anatomi...
66
Functions of matrixFunctions of matrix
 Provision of aProvision of a temporary walltemporary wall of resistanceof resi...
77
ClassificationClassification
 On the basis of chemistryOn the basis of chemistry
 On the basis of thicknessOn the bas...
88
Metallic MatricesMetallic Matrices
CircumferentialCircumferential
 Tofflemire (universal)Tofflemire (universal)
 Auto...
99
Circumferential TypeCircumferential Type
 The band encircles the tooth and isThe band encircles the tooth and is
secur...
1010
Metallic matricesMetallic matrices
Ivory typeTofflemire type
T-band (straight) Curved T-Band
1111
DimensionsDimensions
 The non-contoured bands are available inThe non-contoured bands are available in
two thickness...
1212
Tofflemire matrix bandTofflemire matrix band
 The Tofflemire matrix assembly consistsThe Tofflemire matrix assembly ...
1313
Matrix bandsMatrix bands
•.
1414
Assembled bandsAssembled bands
Fig 12-6
1515
Assembly of tofflemire retainerAssembly of tofflemire retainer
1616
WedgesWedges
1717
WedgesWedges
 Anatomical (triangularAnatomical (triangular
wedges) arewedges) are
recommended for deeperrecommended ...
1818
Role of wedgeRole of wedge
 It should hold the matrix band firmly in positionIt should hold the matrix band firmly i...
1919
TechniqueTechnique
2020
Technique cont.Technique cont.
2121
TechniqueTechnique
 Either precontoured the matrix materialEither precontoured the matrix material
before placing on...
2222
Wedge placementWedge placement
 Simple wedgingSimple wedging
 Piggy-back wedgingPiggy-back wedging
 Double-wedging...
2323
Modification of matricesModification of matrices
All matrices require modification when:All matrices require modifica...
2424
Clear matricesClear matrices
 Polyester stripsPolyester strips
 Mylar stripsMylar strips
 Cellophane stripsCelloph...
2525
Wedges for compositeWedges for composite
 Light reflecting wedges along with clearLight reflecting wedges along with...
2626
PrewedgingPrewedging
 Placement of wedge prior to toothPlacement of wedge prior to tooth
preparation is helpful espe...
2727
AutomatrixAutomatrix
 It’s a retainer less matrix system withIt’s a retainer less matrix system with
four types of b...
2828
Sectional matricesSectional matrices
 Studies have shown that use of sectionalStudies have shown that use of section...
2929
Palodent (sectional matrix)Palodent (sectional matrix)
3030
Apical flap matrix ?Apical flap matrix ?
 Restoring a class II cavity with deeplyRestoring a class II cavity with de...
3131
3232
Questions ?Questions ?
 Is the matrix band stable ?Is the matrix band stable ?
 Does the matrix band fit at the cer...
3333
Preformed Matrix BandsPreformed Matrix Bands
3434
Strip-T Matrix SystemStrip-T Matrix System
3535
CaseCase
3636
3737
3838
3939
Other methods for tighter contacts.Other methods for tighter contacts.
 Use of PTFE tape.Use of PTFE tape.
 Use of ...
4040
Are matrices reusable ??Are matrices reusable ??
 A survey of the use of matrix bands and theirA survey of the use o...
4141
ConclusionConclusion
 The role of matrices in operative dentistryThe role of matrices in operative dentistry
is irre...
4242
 Mullejans R, Badawi MO, Raab WH, Lang H. An in vitroAn in vitro
comparison of metal and transparent matrices used f...
4343
 Rada RE. Achieving anatomic proximal contacts withRada RE. Achieving anatomic proximal contacts with
direct composi...
4444
Thank YouThank You
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Matrix bands

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Matrix bands

  1. 1. 11 Matrices in Operative DentistryMatrices in Operative Dentistry
  2. 2. 22 Matrix ?Matrix ? A matrix is defined as a properlyA matrix is defined as a properly contoured piece of metal or othercontoured piece of metal or other material used to support and give form tomaterial used to support and give form to the restoration during its placement andthe restoration during its placement and hardening.hardening. The art and science of operative dentistry,1995: Mosby-Year Book,Inc.
  3. 3. 33 IntroductionIntroduction  Unfortunately, dentistry does not have a trulyUnfortunately, dentistry does not have a truly satisfactory manufactured matrix for directlysatisfactory manufactured matrix for directly placed restorations.placed restorations.  Most matrices available to the profession haveMost matrices available to the profession have some good qualities but do not meet all thesome good qualities but do not meet all the requisites.requisites.  The primary function of the matrix is to restoreThe primary function of the matrix is to restore anatomical contours and contact areas.anatomical contours and contact areas.
  4. 4. 44 Why do we need matrices ?Why do we need matrices ?  Gingival floor of a class IIGingival floor of a class II cavity is the mostcavity is the most vulnerable area wherevulnerable area where overhang of restorativeoverhang of restorative material can take place.material can take place.  There is no method toThere is no method to control the placement andcontrol the placement and contour of restorationcontour of restoration without a matrix wall.without a matrix wall.
  5. 5. 55 Characteristics of a good matrixCharacteristics of a good matrix  Rigidity.Rigidity.  Establishment of proper anatomical contour.Establishment of proper anatomical contour.  Restoration of correct proximal contact relation.Restoration of correct proximal contact relation.  Easy adaptation to the tooth.Easy adaptation to the tooth.  Ability to be contoured.Ability to be contoured.  Prevention of gingival excess.Prevention of gingival excess.  Strength to offer resistance to condensation.Strength to offer resistance to condensation. pressure.pressure.  Easy removal from the tooth.Easy removal from the tooth.
  6. 6. 66 Functions of matrixFunctions of matrix  Provision of aProvision of a temporary walltemporary wall of resistanceof resistance to the pressure necessary for amalgamto the pressure necessary for amalgam insertion.insertion.  Provision of shape and contour to theProvision of shape and contour to the restoration.restoration.  Maintenance of form during placementMaintenance of form during placement and set of the amalgam/composite.and set of the amalgam/composite.
  7. 7. 77 ClassificationClassification  On the basis of chemistryOn the basis of chemistry  On the basis of thicknessOn the basis of thickness  On the basis of rigidityOn the basis of rigidity  On the basis of circumferenceOn the basis of circumference
  8. 8. 88 Metallic MatricesMetallic Matrices CircumferentialCircumferential  Tofflemire (universal)Tofflemire (universal)  AutomatrixAutomatrix  SiquvelandSiquveland  T-bandT-band SectionalSectional  PalodentPalodent  Composi -tightComposi -tight  IvoryIvory  Strip-T matrixStrip-T matrix
  9. 9. 99 Circumferential TypeCircumferential Type  The band encircles the tooth and isThe band encircles the tooth and is secured by the retainer on the buccal orsecured by the retainer on the buccal or lingual aspect.lingual aspect.  Band may be straight, curved orBand may be straight, curved or contoured.contoured.  Advantage: this type can be firmly adaptedAdvantage: this type can be firmly adapted to the tooth.to the tooth.
  10. 10. 1010 Metallic matricesMetallic matrices Ivory typeTofflemire type T-band (straight) Curved T-Band
  11. 11. 1111 DimensionsDimensions  The non-contoured bands are available inThe non-contoured bands are available in two thicknesses, 0.05mm and 0.038mm.two thicknesses, 0.05mm and 0.038mm.  Contoured matrices may have variableContoured matrices may have variable dimensions (depending upon thedimensions (depending upon the commercial product).commercial product).
  12. 12. 1212 Tofflemire matrix bandTofflemire matrix band  The Tofflemire matrix assembly consistsThe Tofflemire matrix assembly consists of the following:of the following:  Matrix bandsMatrix bands  Matrix retainerMatrix retainer  WedgeWedge
  13. 13. 1313 Matrix bandsMatrix bands •.
  14. 14. 1414 Assembled bandsAssembled bands Fig 12-6
  15. 15. 1515 Assembly of tofflemire retainerAssembly of tofflemire retainer
  16. 16. 1616 WedgesWedges
  17. 17. 1717 WedgesWedges  Anatomical (triangularAnatomical (triangular wedges) arewedges) are recommended for deeperrecommended for deeper and / or wider proximaland / or wider proximal preparations.preparations.  Rounded wedges areRounded wedges are recommended forrecommended for shallower and / orshallower and / or narrower proximalnarrower proximal preparations.preparations. Sturdevant JR et al: Conservative preparation designs for class II amalgam restorations, Dent Mater 3:144, 1987.
  18. 18. 1818 Role of wedgeRole of wedge  It should hold the matrix band firmly in positionIt should hold the matrix band firmly in position cervically.cervically.  It should not be of such a height that it preventsIt should not be of such a height that it prevents the formation of a contact point.the formation of a contact point.  Another function is to separate the teeth slightlyAnother function is to separate the teeth slightly so that when it and the matrix are finallyso that when it and the matrix are finally removed, the teeth return to their originalremoved, the teeth return to their original positions, closing the small space left by thepositions, closing the small space left by the thickness of the matrix band.thickness of the matrix band.
  19. 19. 1919 TechniqueTechnique
  20. 20. 2020 Technique cont.Technique cont.
  21. 21. 2121 TechniqueTechnique  Either precontoured the matrix materialEither precontoured the matrix material before placing on the tooth.before placing on the tooth.  Matrix band can be contoured after beingMatrix band can be contoured after being adapted on the tooth with the help of anadapted on the tooth with the help of an egg-shaped burnisher, back side of theegg-shaped burnisher, back side of the blade of 15-8-14 spoon excavator or bladeblade of 15-8-14 spoon excavator or blade of a Hollenbeck carver.of a Hollenbeck carver.
  22. 22. 2222 Wedge placementWedge placement  Simple wedgingSimple wedging  Piggy-back wedgingPiggy-back wedging  Double-wedgingDouble-wedging  Wedge-wedgingWedge-wedging
  23. 23. 2323 Modification of matricesModification of matrices All matrices require modification when:All matrices require modification when:  proximal surface is a guide plane for tooth/proximal surface is a guide plane for tooth/ tissue supported partial denture.tissue supported partial denture.  Adjacent tooth has a flatter contact.Adjacent tooth has a flatter contact.  Adjacent proximal contours are notAdjacent proximal contours are not normal.normal.
  24. 24. 2424 Clear matricesClear matrices  Polyester stripsPolyester strips  Mylar stripsMylar strips  Cellophane stripsCellophane strips  Plastic stripsPlastic strips  Clear plastic crown formClear plastic crown form
  25. 25. 2525 Wedges for compositeWedges for composite  Light reflecting wedges along with clearLight reflecting wedges along with clear matrices are recommended for compositematrices are recommended for composite restorations.restorations.  Alternatively, ultra thin (0.013mm) metalAlternatively, ultra thin (0.013mm) metal matrices can be used for composites.matrices can be used for composites.
  26. 26. 2626 PrewedgingPrewedging  Placement of wedge prior to toothPlacement of wedge prior to tooth preparation is helpful especially in case ofpreparation is helpful especially in case of composite restorations.composite restorations.  It allows greater separation of the teethIt allows greater separation of the teeth and more space to build a contact.and more space to build a contact.
  27. 27. 2727 AutomatrixAutomatrix  It’s a retainer less matrix system withIt’s a retainer less matrix system with four types of bands, designed to fit allfour types of bands, designed to fit all teeth regardless of circumference.teeth regardless of circumference.  Narrow regular (4.7mm), (0.05mm)Narrow regular (4.7mm), (0.05mm)  Wide regular (7.9mm), (0.05mm)Wide regular (7.9mm), (0.05mm)  Medium thin (6.2mm), (0.038mm)Medium thin (6.2mm), (0.038mm)  Medium regular (6.2mm), (0.05mm)Medium regular (6.2mm), (0.05mm)
  28. 28. 2828 Sectional matricesSectional matrices  Studies have shown that use of sectionalStudies have shown that use of sectional matrices for composite restorations are onmatrices for composite restorations are on a rise.a rise.  Sectional matrices do not only result inSectional matrices do not only result in tighter anatomical contacts but also aretighter anatomical contacts but also are dentist friendly.dentist friendly. Lowe RA. The use of sectional matrix systems in class II direct composite restorations. Dent Today. 2004 Oct;23(10):108, 110-2
  29. 29. 2929 Palodent (sectional matrix)Palodent (sectional matrix)
  30. 30. 3030 Apical flap matrix ?Apical flap matrix ?  Restoring a class II cavity with deeplyRestoring a class II cavity with deeply placed proximal gingival floor orplaced proximal gingival floor or restoration of root caries in proximalrestoration of root caries in proximal surfaces with composite is a restorativesurfaces with composite is a restorative challenge for the dentist.challenge for the dentist.  The feature of apical flap in the design ofThe feature of apical flap in the design of sectional has solved the issue tosectional has solved the issue to considerable extent.considerable extent. A conservative technique for restoring a tooth affected by interproximal root caries. J Prosthet Dent. 2003 Feb;89(2):221-2.
  31. 31. 3131
  32. 32. 3232 Questions ?Questions ?  Is the matrix band stable ?Is the matrix band stable ?  Does the matrix band fit at the cervicalDoes the matrix band fit at the cervical margin ?margin ?  Has the band beenHas the band been burnishedburnished in thein the contact area so that the contact point cancontact area so that the contact point can be restored ?be restored ?  Is the height of the band sufficient ?Is the height of the band sufficient ?  Is the cavity clean and dry ?Is the cavity clean and dry ?
  33. 33. 3333 Preformed Matrix BandsPreformed Matrix Bands
  34. 34. 3434 Strip-T Matrix SystemStrip-T Matrix System
  35. 35. 3535 CaseCase
  36. 36. 3636
  37. 37. 3737
  38. 38. 3838
  39. 39. 3939 Other methods for tighter contacts.Other methods for tighter contacts.  Use of PTFE tape.Use of PTFE tape.  Use of composite inserts.Use of composite inserts.  Incremental composite placement.Incremental composite placement.  Continuous pressure against proximalContinuous pressure against proximal wall.wall.  Class transition technique.Class transition technique. Dunn WJ, Davis JT, Casey JA. Polytetrafluoroethylene (PTFE) tape as aDunn WJ, Davis JT, Casey JA. Polytetrafluoroethylene (PTFE) tape as a matrix in operative dentistry. Oper Dent. 2004 Jul-Aug;29(4):470-2matrix in operative dentistry. Oper Dent. 2004 Jul-Aug;29(4):470-2
  40. 40. 4040 Are matrices reusable ??Are matrices reusable ??  A survey of the use of matrix bands and theirA survey of the use of matrix bands and their decontamination in general dental practicedecontamination in general dental practice.. Lowe AH, Burke FJ, McHugh S, Bagg J.Lowe AH, Burke FJ, McHugh S, Bagg J. The University of Birmingham School of DentistryThe University of Birmingham School of Dentistry..  CONCLUSIONS:CONCLUSIONS: The Siquveland matrix band is the mostThe Siquveland matrix band is the most popular among the study group of dental practitioners. Re-usepopular among the study group of dental practitioners. Re-use of matrix bands is common. Guidelines for the safe re-use ofof matrix bands is common. Guidelines for the safe re-use of matrix bands are requiredmatrix bands are required
  41. 41. 4141 ConclusionConclusion  The role of matrices in operative dentistryThe role of matrices in operative dentistry is irreplaceable.is irreplaceable.  Without a matrix there is no other way (inWithout a matrix there is no other way (in a directly placed restoration) to producea directly placed restoration) to produce contours and contacts.contours and contacts.  No matrix band is ideal, almost allNo matrix band is ideal, almost all proximal cavities need a matrix dependingproximal cavities need a matrix depending on the requirements of the specific case.on the requirements of the specific case. Goldstein MB.It's all in your contacts! A Class II matrix roundup. Dent Today.Goldstein MB.It's all in your contacts! A Class II matrix roundup. Dent Today. 2003 Sep;22(9):60-5.2003 Sep;22(9):60-5.
  42. 42. 4242  Mullejans R, Badawi MO, Raab WH, Lang H. An in vitroAn in vitro comparison of metal and transparent matrices used forcomparison of metal and transparent matrices used for bonded class II resin composite restorations. Oper Dent.bonded class II resin composite restorations. Oper Dent. 2003 Mar-Apr;28(2):122-6.2003 Mar-Apr;28(2):122-6.  El-Badrawy WA, Leung BW, El-Mowafy O, Rubo JH,El-Badrawy WA, Leung BW, El-Mowafy O, Rubo JH, Rubo MH. Evaluation of proximal contacts of posteriorRubo MH. Evaluation of proximal contacts of posterior composite restorations with 4 placement techniques. Jcomposite restorations with 4 placement techniques. J Can Dent Assoc. 2003 Mar;69(3):162-7.Can Dent Assoc. 2003 Mar;69(3):162-7.
  43. 43. 4343  Rada RE. Achieving anatomic proximal contacts withRada RE. Achieving anatomic proximal contacts with direct composite resin restorations.Dent Today. 2000direct composite resin restorations.Dent Today. 2000 Mar;19(3):46-50.Mar;19(3):46-50.  Klein F, Keller AK, Staehle HJ, Dorfer CE.. ProximalKlein F, Keller AK, Staehle HJ, Dorfer CE.. Proximal contact formation with different restorative materials andcontact formation with different restorative materials and techniques. Am J Dent. 2002 Aug;15(4):232-5 .techniques. Am J Dent. 2002 Aug;15(4):232-5 .
  44. 44. 4444 Thank YouThank You

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