2. Advanced Tools In Restoring
Compound Cavities
• Introduction :
• Cavities are classified into :
Simple compound complex
Compound cavities are cavities that include
two surfaces of the tooth , and , due to this ,
undergo the most complications in the filling
procedure .
3. Abbreviation for Two-Surface Restorations (Compound Cavity Restorations )
OB Occluso-buccal
MO Mesio-occlusal
DO Disto-occlusal
DL Disto-lingual
MI Mesio-incisal
LI Linguo-incisal
4. Earlier to any restorative practice undertaken
, a suitable cavity preparation is mandatory.
This clinical step is the mechanical change of
the tooth to accept a restorative material with
which a satisfactory form, function and
appearance of the tooth is obtained.
5. Lately enhancements in materials and techniques have been devised and new skills are now present for
this reason. Recently a CVD coated diamond bur coupled to an ultrasonic handpiece is used in dental
preparation. This technique offers a precise and conservative tooth preparation with ultimate access and
visibility and because of improved efficiency can also aid in the removal some of the patient distress to
the dental treatment.
• At present, there are some different approaches of cutting enamel and dentin
1).Air abrasive instruments , have not extended to common clinical acceptance because of the obstacles of
eliminating residual aluminum oxide dust
2) Another alternative method is the use of laser cutting. Currently, the ErYAG laser’s capability to ablate dental
tissue efficiently, owing to transmission of specific wavelengths absorbed by water and hydroxyapatite, is
observed as the most efficient laser. The little knowledge and the high cost of the equipment has limited its
use. This technology is available to the dentists, but can only be used successfully when clinicians have the
proper information necessary to use them appropriately, and know their benefits as well as their
disadvantages.
6. 3)presently, a special diamond coated bur coupled to an ultrasonic handpiece for dental
applications was established, by covering a molybdenum substrate through a Chemical Vapor
Deposition (CVD) process. This bur is termed CVD by the manufacturer
• CVD characteristics :
1)characterized by a pure diamond cutting surface without a metallic binder between
crystals
2)These burs can be adjusted by a suitable mandrel to almost any ultrasonic handpiece
system found, generating a cutting speed about half that of a conventional rotary
instrument.
Conclusion:
• The ultrasound-coupled CVD bur was observed as an effective technique for tooth
preparation especially compound cavity preparation in this instance. It was effective
and harmless for working close to the gingival margin, and upgraded the operating areaa
visibility, because of access inclination angles that are not available when using a
conventional handpiece.
• The ultrasonic preparation method also relieves the patient from psychological factors
that accompany conventional rotary instruments noise. Consequently, the ultrasonic
cavity preparation using CVD coated diamond bur provides hopeful clinical utility for
certain dental procedures.
9. Instruments that are of most importance in restoration of compound cavities :
A- Dental Matrix :
Definition:
-It is a device used to contour a restoration to simulate that of a tooth structure, which
it is replacing, and it can be defined as; a device during restorative procedures to hold
the plastic restorative with in the tooth while it is setting.
-Matricing is procedure whereby a temporary wall is created opposite to axial walls,
surrounding areas of the tooth structure that were lost during the cavity preparation.
-There is no method to control the placement and contour of restoration without a
matrix wall.
10. Evolution of matrix bands
• Matrices were linear bands that the dentist had to bend them in order to obtain a
form that encircles the tooth
• The shape has been modified, in sizes and finally taking the shape of the tooth.
11. • Classification :
I-Based the mode of retention
a)with retainer eg. tofflemire, ivory no. 1 and ivory no. 8 matrices
b)without retainer eg. automatrix
II-Based on type of band material:
a)Celluloid
b)cellulose acetate(cellophane)
c)cellulose nitrate(mylar)
d)copper band
III-Based on its preparation:
a)custom made or anatomic matrix eg. compound supported matrix
b)mechanical matrix eg. tofflemire, ivory no. 1 and ivory no.8 matrices
IV-Based on transparency :
12. I-Based on the mode of retention
a) With a retainer
Ivory NO.1 matrix:
-Consists of a stainless steel band which encircles one proximal surface of a
posterior tooth.
Ivory NO.8 matrix:
-Consists of a band that encircles the entire crown of the tooth.
13. Tofflemire matrix: (Universal matrix)
-This is the most recent development and is usually
preferred for most class II amalgam restoration.
14. b)Without retainer
-Automatrix:
-It is a retainerless matrix system.
-Automatrix bands are available in thickness of 0.0015 to 0.002 inch. and they may be
of 3 widths
-They may be selected according to the height of the tooth to be restored
-Bands are already formed into a circle and are available in assorted sizes in both
metallic and plastic
16. III-Based on its preparation :
a) Compound supported matrix:(Custom made or anatomical matrix)
-Its is entirely hand made and is contoured specifically for indivdual cases.
-Following this amalgam condensation and carving can be done.
-To be removed the matrix the compound can be broken away with a sharp explorer and
the matrix strip can be removed.
b) Mechanical matrix :eg. tofflemire, ivory no. 1 and ivory no.8 matrices
17. IV- Based on transparency :
a) Transparent :Transparent plastic crown form matrix:
-They are available in various sizes and contours for anterior teeth
-The bulk of the composite resin is loaded into the crown form. This is then positioned over the
crown form and then placed over the tooth and light cured. Thus the contours of the tooth can
be shaped easily. After curing , the crown form can be slit with a bur and removed.
Preformed transparent cervical matrix:
-Used in anterior and posterior teeth.
-They are designed for use with light cured composite resins or GIC’s.
-A tweezer or a handle can hold the matrix in place while the restoration is hardening.
18. • RECENT PRODUCTS
1. V3 Matrix (Triodent) –Pronounced ridge
on the occlusal margin with rolled
edge for marginal ridge buildup.
2.Convexi-T Convex Tofflemire
matrix band (Clinician’s choice) –Precontoured
buccally/ lingually and occlusally/ gingivally.
. They facilitate the creation of
interproximal contours .
3.SuperMat(Kerr) –Universal matrix
tensioning system designed to
facilitate large-scale direct restoration of posterior
teeth.
19. 4.Fender Mate flexible wing (DirectaAB) –Separates
the teeth, pressing the matrix toward the
cervical margin, avoiding overhang.
Optimal curvature and preshaped contact.
5.Composi-Tight 3D Sectional
Matrix System (Garrison Dental Solutions)
–Soft Face
3D-Ring with contoured soft-silicone
faces that mold sectional matrix
bands to the teeth.
6.Slick Bands (Garrison Dental Solutions) –Prevent
bonding agents from sticking to the matrix
band by applying a micro thin coating to
their stainless steel matrix bands.
7.Omni-Matrix Sectional (Ultradent) - 4 distinct
matrix bands that are extremely thin and flexible.
20. WEDGES :
-Third component of the matrix system.
-Wedging provides rapid or immediate separation. The separation achieved is based on the wedging
principle.
Wedges are made of:
- Wood, Plastic or celluloid, Metal,Silver, Medicated wooden wedges .
Wooden wedges are preferred because They are easy to trim with a scalpel and they adapt
well to the tooth surface. When properly shaped they remain stable during condensation. Also
absorb moisture and swell to provide adequate stabilization.
Shapes:
Triangular or round
21. The wedge ought not infringe towards the contact range: this will misshape the network and
leave a huge approximal hole under the contact point.
In areas of difficult anatomy (eg: canine furrow on mesial part of Upper first premolars) more
than one wedge may be required to seal pit.
22. • The injection-Molded technique
• Before starting the method, if a lot of dentin is available, that dentin is either secured with glass ionomer
or dentin holding operators.
• The injection-molded composite dentistry method calls for first applying bonded resin to both the
beforehand treated dentin and the recently etched enamel inside the matrix
• then infusing a flowable composite into the pool of the supporting resin, and after that at last infusing the
paste composite.
• The resin-flowable-paste mass is polymerized together in a solitary light-cure.
• In the creator's procedure, he aims for the paste composite to make up 80% to 90% of the general volume
of the filling, while flowable ought to represent 10% to 20%. With customarily square shaped
preparations, it is basic to see restorations with 50% to 70% of the general volume made up by flowable
composite.
• That sum of flowable can add to unsatisfactorily high rates of marginal ridge fracture and complete filling
dislodgement.
• New materials
23. • New materials
• The EQUIA™ Fil is a bulk
filled with radiopaque posterior restorative
material in capsules.
• The material used is called Verionomer.
24. A coat isneededafterfinishing
the fillingtoprotectthe
material.Verionomerhas
higherrate of wearthan
Composite andAmalgam.
An upside tousingthis
material,isthatthere isa low
percentage of breakingthe
toothwhere there isa wall thin
enoughtobe removedinthe
normal case of using
Composite orAmalgam.
Thisprocedure takeslesstime andismore accurate comparedto manual mixingof GCFuji X 9.
