The Story
A number of problems have been associated with using resin composite for posterior restorations, including staining, marginal ditching, post-operative sensitivity, increased wear compared to metallic restorations, and difficulties in obtaining adequate interproximal contacts. In an effort to overcome this latter problem, The Palodent Sectional Matrix System can be use.
The Palodent Sectional Matrix System is a sectional matrix system for use during placement of interproximal fillings (amalgam or composite restorations or temporary). The kit contains pre-contoured metal matrix forms (three sizes/shapes) and BiTine® rings (two styles) for matrix retention and tooth separation. The shaped matrices are designed to enhance reproduction of natural proximal shape and post-operative contact. The purpose of the BiTine ring is for initial separation of the teeth. The spring-action of the ring creates separation of the teeth facilitating inter-dental preparation space as well as formation of a positive proximal contact.
Using Palodent
The procedure for using the Palodent Sectional Matrix System for a Class II resin composite restoration is the following (see the video):
- Using a rubber dam clamp forcep, apply the BiTine ring interproximally (between the tooth to be prepared and the adjacent tooth pre-operatively.
- After completion of the preparation the BiTine ring is removed
- The sectional matrix and wedge are applied
- The matrix is burnished against the adjacent tooth
- The BiTine ring is replaced
- The resin composite restoration is placed.
Evaluation
“The Palodent Sectional Matrix System easy to use and the packaging convenient. There is a tendency for matrices to stick together in the package. The selection of matrix sizes and shapes and the new ring clamp style were highly rated. The resultant proximal contacts and contours were very good. Removal of the matrices after filling placement is not a problem. The rings are easy to place, stable after being placed and maintain good tension against the teeth; long-term tension in the rings is excellent. The two different shaped rings provided a versatile addition to the technique.” -dentaladvisor.com-
“The Palodent Sectional Matrix System ring produced effective pre-placement wedging as well as matrix contouring. Some evaluators felt that contacts obtained were actually too tight and required additional finishing time to reduce the contacts to the appropriate level. Evaluators judged that the BiTine ring can be awkward to place (this problem can be solved using the "BiTine.ii" that has two sockets for engaging the forceps), is not stable in all clinical situations, may be difficult to place if preparation has large facial or lingual extensions and is difficult to place on either side of wedge (can only be placed occlusal to wedge). Overall, the evaluators were satisfied with the system as a means for placing posterior resin composite restorations, and noted that it provided better interproximal contact and proximal contours for posterior resin composite restorations than traditional matrices (e.g., Tofflemire).” -USAF Dental Evaluation & Consultation Service-
Clinical Tips
- Burnishing the matrix before placing restorative material is helpful in creating both shape and contact tightness desired.
- Wedge the matrix for stabilization and gingival margin closure.
- Use of flexible wedges helps improve contacts.
Source
http://airforcemedicine.afms.mil/idc/groups/public/documents/afms/ctb_109756.pdf
