2. WEDGEWedges are small, tapering, triangularpieces of wood or clear plastic about1/2 inch in length.
3. WEDGE PLACEMENT
4. SIZE & SHAPESIZE:- 12 inches(1.2CM)Wedges areavailable in varioussizes, which may becolor coded. Theyare either plain(straight) oranatomically(triangular) shaped.
5. Wedges come inmany sizes andshapes and can becustomized foralmost any situation.If the proper sizecan not befound, they can bemodified to fit theinterproximal areaby cutting the woodaway.
6. MODE OF INSERTIONBreak off approximately inch ofa round toothpick. Grasp thebroken end of the wedge withthe no. 110 pliers. The wedge isgenerally placed on thelingual, away from the side ofthe tooth on which the retaineris located. The lingualembrasure is also usually thewidest of the twoembrasures, and therefore isoften in greater need of theadaptation of the band by thewedge.
7. POSITION & PLACEMENTA wedge should be positioned as near to the gingivalcavosurface margin as possible without being occlusal to it.If necessary, the gingival aspect of the wedge may belightly wetted with lubricant to facilitate its placement.The wedge not only stabilizes the matrix but moreimportantly it is placed below the gingival cavosurfacemargin to prevent amalgam from flowing beyond thecavosurface margin in that area. This area is the mostinaccessible area for carving instruments, therefore it iscritical to place a wedge that will prevent excess amalgamflowing beyond the gingival margin and forming overhangs.
8. If the wedge is placed occlusal to the gingival margin, the band willbe pressed into the preparation, creating an abnormal concavity inthe proximal surface of the restoration. The wedge should not be sofar apical to the gingival margin that the band will not be held tightlyagainst the gingival margin. This improper wedge placement willresult in gingival excess caused by the band moving slightly awayfrom the margin during condensation of the amalgam. Such anoverhang often goes undetected and may result in irritation of thegingival or an area of plaque accumulation. Correct Correct & Incorrect wedge position
9. PIGGY BACK WEDGE If the wedge issignificantly apical of thegingival margin, a second(usually smaller) wedge maybe placed on top of thefirst to wedge adequatelythe matrix against themargin. This type of wedging isparticularly useful forpatients whoseinterproximal tissue levelhas receded.
10. TIGHTNESSThe gingival wedge should be tight enough to preventany possibility of an overhang of amalgam in at leastthe 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 fromthe lingual embrasure and one from facial embrasure. Two wedges help to ensure that the gingival cornerof the wide proximal box can be properlycondensed,they also help to minimize gingival excess. However double wedging should be used only if themiddle two third of the proximal margin can beadequately wedged.Because of the facial and lingual corner areaccessible to carving proper wedging is important toprevent gingival excess of amalgam in the middle twothird 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 inthis area may be concave. Towedge a matrix band tightlyagainst such a margin asecond pointed wedge canbe inserted between the 1stwedge and the band. This isreferred as wedge wedgingThe wedging action betweenthe teeth should provideenough separation tocompensate for thethickness of the matrixband. This will ensure apositive contact relationshipafter the matrix is removed
15. TEST FOR TIGHTNESS OF THE WEDGETest for tightness of the wedge bypressing the tip of an explorerfirmly at the several point along themiddle two thirds of the gingivalmargin (against the matrix band) toverify that it can not be move awayfrom the gingival margin. As anadditional test, attempt to removethe wedge (using the explorer withmoderate pressure) after firsthaving set the explorer tip into thewood near the broken end.Moderate pulling should not causedislodgement.
16. Use explorer tip (with pressure) to ensure properadaptation of band to gingival margin. Press anddrag the tip of the explorer along the gingivalmargin in both directions to ensure to removal ofany remaining friable enamel.
17. TRIANGULAR (ANATOMIC) WEDGEThe triangular (i.e., anatomic)wedge is recommended for apreparation with a deep gingivalmargin.The triangular wedge is usuallyindicated with the tofflemire MODmatrix band. The triangular wedge is positionedsimilarly to the round wedge, andthe goal is the same.
18. When the gingival margin isdeep (cervically) the base ofthe triangular wedge will morereadily engage the toothgingival to the margin withoutcausing excessive soft tissuedisplacement.The anatomic wedge ispreferred for deeplyextended gingival marginsbecause its greatest cross-sectional dimension is at itsbase.
19. CUSTOM MADE TONNGUE BLADE WEDGEA suitably trimmed tongue bladecan wedge a matrix where theinterproximal spacing betweenteeth is large.Occasionally, however, it isimpossible to use a wedge to securethe matrix band . In this case, theband must be sufficiently tight tominimize the gingival excess ofamalgam. Because the band is notwedged, special care must beexercised by placing small amountsof amalgam in the gingival floor andcondensing the first 1 mm ofamalgam lightly, but thoroughly, in agingival direction.
20. SUPPORT WITH HOLLENBACK CARVER BLADESupporting the matrix materialwith the blade of a Hollenbeckcarver during the insertion ofthe wedge for the difficult deepgingival restoration may behelpful. The tip of the blade isplaced between the matrix andgingival margin and then the“heel” of the blade is leanedagainst the matrix and adjacenttooth.In this position the bladesupports the matrix to helpboth in positioning the wedgesufficiently gingivally andpreventing the wedge frompushing the matrix into thepreparation. After the wedge isproperly inserted, the blade isgently removed.