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Black class I. and II. composite fillings Dental matrix systems and its use DR. KÁROLY BARTHA

Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

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Page 1: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Black class I. and II.

composite fillings

Dental matrix systems

and its useDR. KÁROLY BARTHA

Page 2: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Black Class I.

definition

extended fissure sealing

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Page 3: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Black Class II

definition

MO/OD/MOD

3

Page 4: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Limits of the use of composits

Not indicated:

problems with isolation

full contact with opposite tooth

bruxism

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Page 5: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Usual Steps of an Composite

Restoration

Medical history, diagnosis, (X-ray.) Anesthesia

Shade selection

Cavity preparation

Isolation

Adhesive technique

Inserting and curing the composite

Contouring and polishing the composite

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Page 6: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Shade selection

Drying and dehydration of the tooth

Isolation (before-, color)

Applying and curing a small amount of the

composite

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Page 7: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Adhesive technique

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Page 8: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Inserting and curing the

composite

Class I.

Class II.

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Page 9: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Disadvantages of the

composite

Polymerization shrinkage

Higher thermal expansion coefficient

No adhesion or chemical bond

Solution - adhesive technique

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Page 10: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

C-factor (configuration-factor)

The ratio of bound-to-unbound surface

areas

10Sturdevant‘s Art &Science of Operative Dentistry 4th ed. Mosby

Page 11: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Methods of reducing the

polymerization shrinkage

Further development of the composite

Incremental filling technique

Direction of the curing light

Method of the curing

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Page 12: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Incremental filling technique

Horizontal – occlusogingival layering

when cavity< 1/3 width of the toot

Oblique layering

Faciolingual layering

Bulk-fill

Bio-mimetic

Horizontal-split technique

Centripetal technique

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Page 13: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Increment technic

- occlusogingival layering

Wide cavity – fracture

13

Page 14: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Increment technic

- oblique layering

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Page 15: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Increment technic

- use of flow composite

Better marginal seal

„Stress-breaker” function

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Page 16: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Increment technic

- faciolingual layering

16

Page 17: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Increment technic

- bulk-fill

17

Page 18: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Increment technic

- bulk-fill

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Page 19: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Increment technic

- bio-mimetic

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Page 20: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Direction of the curing light

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Page 21: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Method of the curing

„Soft start” polymerization

As near as possible

Metal matrix can inhibit

Diameter of the light guide

Cleanness of the light guide

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Page 22: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

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Page 23: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Method of the curing

„Soft start” polymerization

As near as possible

Metal matrix can inhibit the effect

Diameter of the light guide

Cleanness of the light guide

23

Page 24: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Black Class II. composite

fillings

24

Page 25: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

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Page 26: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

When are the matrix systems

necessary?

Preparation

to protect the neighboring tooth

Plastic fillings

to shape (proximal contact)

for replacement of missing wall(s)

during the cementation of inlays/onlays

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Page 27: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Expectations - use of matrix

system

No gap, good seal

Proximal contact

Higher than the tooth

Well fixed

Easily removable

Transparent

Impermeable

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Page 28: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Matrix is usable when…

There are some place between the teeth

If not, we make

Horico strip

Fast-separation (wedge)

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Page 29: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

We use the matrix strip

(fast every time) with a wedge

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Page 30: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Use of the wedge

To put the matrix strip to the tooth

To fix the matrix strip

Separation

(Bleeding control)

To protect the interdental papilla

Light transmitting wedge - polymerization

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Page 31: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

The use of the wedge

32Sturdevant‘s Art &Science of Operative Dentistry 4th ed. Mosby

Page 32: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

The use of the wedge

33Sturdevant‘s Art &Science of Operative Dentistry 4th ed. Mosby

Page 33: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

The use of the wedge

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Page 34: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Wedges

Wooden

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Page 35: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Wedges

Plastic

Formed

Curved (Curvy, VoCo)

V-shaped

Light transmitting

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Page 36: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

During preparation

Common metal matrix

Special product

„Matrix”

Wedge

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Page 37: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Plastic fillings

Black Class III. and IV.

Root surface fillings

Black Class II.

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Page 38: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Front-teeth - Black Class III.

Transparent matrix – polyester strip

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Page 39: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Hawe Stopsrip

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Page 40: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Front-teeth Black Class IV.

Polyester strip

Silicone key

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Page 41: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Use in U-shape (from Tuza E.)

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Page 42: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Silicone key (from Tuza E.)

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Page 43: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Cervical fillings – cervical matrix

Composite

GIC

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Page 44: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Cervical fillings

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Page 45: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Black Class II.

Dental amalgam – metal matrix

Composite –metal- or plastic matrix

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Page 46: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Matrix + matrix retainer or

holder together (wedged)

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Page 47: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Amalgam filling

Dental amalgam is condensable - tight

proximal contact

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Page 48: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

MO or OD cavity

Ivory matrix retainer + matrix band

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MOD cavity

Conventional matrix retainer – with matrix

band

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MOD cavity

Tofflemire matrix retainer with Tofflemire

matrix band

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Page 51: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

MOD cavity

Tofflemire matrix retainer with Tofflemire

matrix band

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Page 52: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Conic matrix band –

disadvantageous form

During finishing proximal

contact disappeared

Fracture of filling

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Page 53: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Composite filling

It could be difficult to achieve a tight

proximal contact

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Page 54: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Tofflemire matrix retainer with

plastic matrix band

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Page 55: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Lucifix (KerrHawe)

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Page 56: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Special matrix systems

AutoMatrix (Dentsply)

MaximatPlus (Polydentia)

SuperCap (KerrHawe)

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Page 57: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

The use of matrices

58Sturdevant‘s Art &Science of Operative Dentistry 4th ed. Mosby

Page 58: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Special matrix system – Walser

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Page 59: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Special matrix systems –

sectional matrix

Palodent / Palodent Plus (Dentsply)

Hawe Adapt sectional matrix system

(KerrHawe)

Quickmat (Polydentia)

V-ring (TrioDent)

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Page 60: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Special matrix systems –

sectional matrix

Matrix is formed

Ring to fix

Forceps

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Page 61: Black class I. and II. composite fillings Dental matrix ...semmelweis.hu/konzervalo-fogaszat/files/2016/03/I_II_KOMP_MATRICA... · Black class I. and II. composite fillings Dental

Special matrix systems –

sectional matrixV V3 V4

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Special matrix systems

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Special matrix systems – rings

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Special matrix systems –

forceps

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Special matrix systems – the use

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Thank you for your attention!67