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Matrices

This document discusses tooth separation techniques and matrices used in dental restorations. It covers two main topics: 1. Separators: Devices used to rapidly or slowly separate teeth during dental procedures. Rapid separators include wedges and Elliot separators, while slow separators include rubber bands, wires, and oversized temporary crowns. 2. Matrices: Devices that create a temporary wall for dental restorations when tooth structure is missing. Various matrix types exist for different cavity classes, including Tofflemire matrices for Class II cavities, shaped strips for Class III/IV, and window matrices for Class V. Matrices are made of materials like metal, cellophane or mylar and aim to confine

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Overview of separators and matrices for various cavity preparations including Class I to V.

Explains tooth movement, reasons for separation, and principles of mechanical methods.

Detailed discussion on mechanical separation methods including fast and slow techniques.

Description of wedges, their ideal characteristics, and classification for effective dental procedures.

Innovations in dental wedges like Palodent plus and elastic wedges for improved isolation.Introduction and classification of matrices for various cavity preparations, highlighting their functions.

Details on specific matrices for Class I, II, III, IV, and V cavity preparations, including unique forms and indications.

References used for the presentation and thanks to the audience.

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Tooth seperation and Matricing Presenter：Dr. Sheetal Kotni
1. Seperators 3. Matrices • Matrices for Class III cavity prep: • S shaped matrix • Transparent strips Matrices for Class IV cavity prep: • L shaped matrix • Transparent crown forms • Anatomic matrix Matrices for Class V cavity prep: • Window matrix • Cervical matrix • Anatomic matrix Matrices for Class III, IV, V cavity prep: • Bioclear • Unica • Introduction • Functions • Reasons for seperation • Principles of tooth movement • Types of seperators • Introduction • Definitions • Ideal requirements • Objectives • Parts • Classification • General priniciples of placement and removal 2. Wedges • Introduction • Ideal requirements • Classification • Wedge placement • Techniques of wedging • Recent advances:  Wedgeguards  Anatomic wedges  Elastic wedges Matrices for Class I cavity prep: • Barton matrix Matrices for Class II cavity prep: • Universal tofflemire • Omnimatrix • Slick bands • Contouring of the matrix band • Ivory 1, 8 • Black's matrices • Steele's siqveland matrix • Compound supported matrix • Copper band matrix • T band matrix • Automatrix and modifications • Reel matrix • Pinch matrix • Sectional matrices  Method  Contact rings  Classification, • Contact forming instruments CONTENTS
1 3 2 Tooth movement is the act of either seperating the involved teeth from each other, bringing them closer to each other and or changing their spatial position in one/more dimensions INTRODUCTION To facilitate the creation of physiologically functional contact, contour and occluding anatomy in the restored teeth Function Diagnosis of proximal caries, Reposition drifted teeth, matrix placement, polishing restoration,remove the foreign bodies impacted proximally Reasons for seperation 1 SEPERATORS
Principal methods of tooth movement Rapid/immediate tooth movement Wedge principle:Elliot seperator, wedges Traction principle:Non interfering true seperator, Ferrier double bow seperator Slow or delayed tooth movement Rubber dam sheet Seperating rubberband Seperating ligature wires Oversized resin Temporary crowns Orthodontic appliances
Rapid tooth movement: Mechanical type of seperation that creates either proximal seperation at the point of seperator's introduction or improved closeness of the proximal surface opp. the point of operator's introduction Wedge method: More the wedge moves facially or lingually when placed proximally, more the seperation Wedges Elliot seperator Indications: For short duration seperation that doesnt necessitate stabilization Examining proximal surface and final polishing of restored contacts Tooth seperation should not exceed 0.2- 0.5mm else damage and tenderness to pdl
• Adjust the two opposite wedges of the seperator interproximally so that they are positioned gingival to contact area not impinging on interdental papillae or interceptal rubber dam. Move the knob clockwise so that the wedges move towards each other establishing desired seperation
Traction principle Non interfering true seperator Indicated when continuous stabilized separation is required during the dental operation. Pros: separation can be increased or decreased after stabilization, non- interfering Ferrier double bow seperator The separation is stabilized throughout the operation. Pros- separation is shared by the contacting teeth, and not at the expense of one tooth, as with the previous type of instrument Always done with mechanical device which engage the proximal surfaces of the teeth to be seperated by means of holding arms. These are mechanically moved apart, creating seperation between clumped teeth
Slow(delayed) tooth movement Rubber dam sheet Seperating rubber band Seperating wires Oversized resin temporary crowns Orthodontics appliances A small piece of heavy or extra heavy rubber dam sheet can be stretched and positioned in the contact area Thin pieces of wires are introduced beneath the contact area to form a loop around the contact area. The two ends can be twisted together to create a seperation not beyond 0.5mm. Oversized mesiodistally and periodically resin is added in the contact areas to increase the amount of seperation Most effective and predictable Used only when extensive respositioning is required The wires can be tightened periodically to increase the seperation Indication: When teeth have drifted considerably, rapid movement of teeth will endanger the pdl.Therefore,slow tooth movement, over a period of weeks, will allow the proper positioning of teeth in a physiological.
2 Wedges Devices which create rapid seperation of teeth during preparation and restoration Commonly used to prevent overhangs at the proximal area which is an iatrogenic cause of periodontal pathology
Ideal requirements • Easy to apply and withdraw • Shaped to minimize the risk of trauma to gingival and periodontal tissues • Supplied in range of shapes and sticks • Shaped to facilitate the restoration of proximal contours so that the deformation of matrix band does not occur • Disposable • Radiopaque • Rigid • Non toxic, non irritant • Stable in oral fluids • Not fracture • Available in bright colours
Classification of wedges • Long/short • Hard/soft • Rigid/compressible • Wooden/plastic • Medicated/non medicated • Round/anatomic • Prefabricated/customized • Reflecting/non reflecting
Palodent plus wedge guard/ fender wedges • Isolation and protection during restorative treatment • Matrix and wedge in one step, fast adaptation even in the most complicated interproximal spaces. Easy to use, control and removal for the fabrication of Dental restorations. • Available in 3 different colour coded sizes. Contains 50 units. • Inserted into the inter dental space it provides a protector for the tissue and separates the teeth, simplifying the following application of a matrix. • Can be applied buccally or lingually for optimal access and vision.
Triodent anatomic wedges
Elastic wedges • For rubber dam placement and isolation • Autoclavable • Mostly used in tight contact cases
3 Introduction 1. Class I cavity: No need of matricing due to confining walls 2. Matrices: Establish a temporary wall for the restoration when one or more walls of tooth are missing 3. The word matrix is derived from the Latin word Mater’ which means Mother. It was introduced in the year 1871 by Dr. Louis Jack MATRICES
Definitions 1. is the procedure, whereby a temporary wall is created opposite to axial walls and surrounding areas of tooth structure that were lost during preparation 2. is a device used during restorative procedures to hold the plastic restorative material within the tooth while it is setting.
Ideal requirements 1. Ease of application 2. Not be cumbersome: for restoration condensation or patient comfort 3. Ease of removal after hardening of restoration 4. Rigidity: To confine the restorative material during condensation without displacement 5. Versatile enough to provide proper contact and contour in various situations 6. Positive proximal pressure against the tooth during restoration insertion 7. Non-reactive 8. Inexpensive
Objectives • It must act as a temporary wall of resistance during introduction of the restorative material. • It should provide shape to the restoration. • It should confine the restoration within acceptable physiological limits. • It must assist in isolating the gingiva and rubber dam during introduction of the restorative material • It must help in maintaining the dry operative field thereby preventing contamination of the restoration.
Parts 1. Band: Piece of metal or polymeric material used to support and give form to the restorative material during its insertion and hardening. e.g. cellophane, celluloid, mylar. Available as strips of various dimensions: 0.001-0.002 inch thickness 3/16 inch, 1/4 inch, 5/16 inch width 2. Retainer: Device by which the band can be maintained in its designated position and shape. e.g Mechanical device, dental floss, metal ring or impression compound
1. Custom-made or anatomic matrix. e.g Compound matrix 2. Mechanical matrix e.g Ivory 1, 8, Tofflemire Depending on its prep 1. Stainless steel 2. Copper band 3. Cellophane (cellulose acetate) 4. Polyacetate (mylar) Depending on the type of band material 1. With retainer e.g. Tofflemire, Ivory 1, 8, Steele's Siqveland matrix, Sectional matrix 2. Without retainer e.g. Automatrix, Copper band, Al band, Black's matrices, Anatomic matrix, S shaped , T shaped, L shaped matrix, Depending on the mode of retention 1. Class I cavity with buccal or lingual extension 2. Class II cavity 3. Class III cavity 4. Class IV cavity 5. Class V cavity Depending on the cavity preparation for which it is used Classification
Class I cavity with buccal or lingual extension E.g Double banded tofflemire matrix Class II cavity • Single banded tofflemire • Ivory 1, Ivory 8 • Compound Supported matrix • Copper band, T band, precontoured matrices • Automatrix Class III cavity • S Shaped matrix • Cellophane strips • Mylar strips Class IV cavity • Cellophane strips • Transparent celluloid crown forms • Dead soft metal matrix strips Class V cavity • Window matrix • Tin foil matrix • Preformed transparent cervical matrix Depending on the cavity preparation for which it is used
Matrices Patented/Non- patented Patented All matrix with retainer Non-patented You yourself modify for a particular clinical situation Circumferential/ Unilateral Circumferential Ivory 8, Steele's Siqveland Matrix, Tofflemire Unilateral Ivory 1, Sectional matrix
Matrices Supported/ Unsupported Anterior/ Posterior Sterilisable/ Disposable Non trasparent/ Transparent
GENERAL PRINCIPLES OF PLACEMENT AND REMOVAL OF MATRIX SYSTEMS Check for contacts, contours Pre-wedging if required in case of tight contacts Selection of matrix system Contouring of band Placement of matrix system Wedge placement, Support with compound if required Inspection of proper placement Restoration of cavity Removal of compound, wedge, matrix Check for contact, contours clinically, radiographically
Matrices for Class I Cavity Preparation
Indication; Class I cavity with buccal or palatal extension Since the tofflemire retainer with band doesn't intimately adapt to lingual groove- land sliding Stainless steel matrix (0.05 mm thick and 8 mm wide) between the lingual surface and the band already in place • A quick setting, rigid polyvinyl siloxane (PVS)–based material/ • Green stick compound/ • The end of a toothpick wedge is covered with softened (heated) compound may be used between the sectional matrix and the Tofflemire matrix band, to prevent lingual displacement of the sectional matrix during condensation Double Banded Tofflemire Matrix or Barton matrix
Matrices for Class II Cavity Preparation
Universal Tofflemire Matrix • Navy dentist, Dr. Benjamin Franklin Tofflemire, 1946 • Made universal by the easy application and removal of the holder from the band without disturbing the condensed material • The retainer can be removed without the band-more pt. comfort • Helps to hold the cotton roll in place
• Head is directed gingivally • Set screw (1), rotating spindle (2), slide (3), head (4), band (5). • The slide is positioned near the head for installation of the band in the retainer and for placement of band around tooth • Rotating spindle/ vice moving nut adjusts the distance between the slide and the head. This movement adjusts the size of the loop • Set screw/ vice screw nut locks and unlocks the matrix band
• The junction bw retainer and band should always be next to intact tooth surface for stability and prevention of unnecessary restorative material accumulation
Tofflemire bands Ac to thickness Ultra thin:0.001 inch Thin: 0.0015 inch Medium: 0.0020 inch Flat bands of multiple shapes Precontoured bands-little or no adjustment Larger circumference - occlusal edge Smaller circumference- gingival edge
Contouring of the matrix band Outside the patient mouth Inside the patient mouth Band should be placed on a resilient paper pad because contouring cannot occur on a non resilient surface After placing the band and retainer, the band is burnished against the adjacent tooth with burnisher Used with firm pressure in back and forth overlapping strokes The convex side of a spoon excavator imparts a convex contour to the matrix band
2 thicknesses of metal bands: .0015”, ultra thin .001” Preassembled and disposable tofflemire retainer and band Less time consuming Single piece, plastic lightweight retainer with .002” mylar/metal bands Winged or wingless Expensive Omnimatrix Pivoting head Simply adjust the band's circumference by twisting the conical handle.
• Proprietary non-stick Slick Bands™ technology • Improved tear-resistant dead-soft matrices Slick Bands™ Tofflemire-Style Kit
Ivory No. 1, 8 Ivory 1 Ivory 8 Stainless steel band encircles one proximal surface of posterior tooth Encircles entire crown of the tooth • Indicated in unilateral class 2 cavities • Tight distal contact Indicated in Unilateral/bilateral Class II(MOD) of posterior teeth Band attached to the retainer with a wedge shaped projection which engages the tooth at the embrasure of unprepared surface Cumbersome to place Molar Premolar
BLACK'S MATRICES STEELE'S SIQVELAND MATRIX G. V. Black, 1900 The matrix consists of a circumferential band with a thumbscrew retainer Recommended for majority of small and medium sized cavities Indicated for restorations of three or more surfaces Black's matrix with a gingival extension: to cover the gingival margin of a subgingival cavity, a wire/floss is tied to the band to prevent slippage and tied around the tooth
Compound supported Matrix system Shape of matrix after trimming Contouring Burnishing Placement, wedging, compund support with cone Contour altered by warm burnishing instrument
Copper band matrix • Band stabilized with low fusing compound, pushed against the adjacent tooth • After carving, cut on b/l and then remove
T BAND MATRIX • T shaped band • When formed, the top portion of the T allows the straight portion to adjust and fit the circumference • Curved/straight • Narrow/wide • Brass/steel • The band is held in place with a flexible metal ring: contact ring, placed with special forceps and stabilizes the ends of matrix band snugly
AUTOMATRIX (ROLL-IN BAND)
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Modifications of automatrix • Metal Dental Bands Retainerless Universal Supermat Automatrix
Reel matrix by Garrison
Pinch matrix: Pinch towards tooth for tension • Introduced by Kerr • For Class II MO/OD/MOD composite fillings in posterior area with the innovative integrated opening system. • The ring matrix band is 0.038 mm for stable placement without distortion through tight intact contact points. • Three sizes • Excellent patient comfort and better visibility of the working area.
SECTIONAL MATRIX AND CONTACT RING • KHB
• The sectional matrix system and separation rings are made up of nickel-titanium alloy to create a consistent force to separate teeth and then return to their original shape after use, helping to deliver a tight gingival seal and anatomically shaped restoration. Precontoured bands of different dimensions G ring/ bitine rings
• D Place a matrix band that most closely approximates the occluso-gingival height of the tooth. The band should be oriented with concave edge towards the occlusal margin of the tooth. Insert wedge Apply the 3D –ring retainer. Hold the ring retainer with the ring placement forcep and place it over the wedge. Burnish the band in the desired contact area against the adjacent tooth and make sure there is no springback of the band Restore the cavity as desired. Remove the ring, wedge and band. Removal of the ring and band may require the need of forcep
• First report of a contoured sectional matrix: Meyer • Concept based on the MCKean orthodontic seperator is the surest method of achieving good contacts • Two equal and opposite forces cause seperation of teeth: McKean principle
Contact rings • According to their evolution, categorized as First generation systems Second-generation systems • First generation systems Introduced in the late 1990s Include :- • Palodent Bitine • Contact matrix • Composi-Tight
Palodent BiTine I and BiTine II • First system that was available. • Rings have rectangular parallel tines. • Optimum separation (0.55 kg/mm). • Lack of retentive design because of the parallel tines but are easy to place on wide preparations. • BiTine II is an elongated ring to allow stacking over the main ring in case of MOD preparations
Contact matrix • These rings have rectangular tines which are converging and hence are more retentive. • Provide optimum separation (0.38 kg/mm). • A reverse ring is available for MOD preparations.
Composi-Tight matrix • Two separate rings are available for premolar and molar teeth. • The rings have converging tines with retentive balls at the end for firmer grip on the teeth. • Omnidirectional. • Drawback: Contacts produced are not so tight (0.27 kg/mm). • Large diameter of the rings can lead to their collapse if used in wide cavities
Problems with early contact rings • Ring collapse or displacement in case of wide proximal boxes. • Ring stacking that is, placing one ring over the other in case of MOD restoration is a problem. • Most importantly, since the contact rings are made of stainless steel, repeated usage and sterilization effects make them lose their springiness over time
Second - Generation Rings Composi-Tight 3D soft face ring system The orange Soft Face 3D-Ring The gray thin tine G-Ring • Used in most circumstances • Ease of placement • Burnished tine ends Ability to adapt to a wide variety of tooth anatomies while reducing flash and restoring proper contour Used where the shape of the dentition makes ring retention more problematic
V3 ring system Dr. Simon McDonald in 2008 2 types of rings for bicuspid and molar teeth • Precontoured matrix bands • Special wedge called the ''wave wedge''to provide optimum gingival adaptation of the matrix band. It has two major innovations • Fully made of Nickel-Titanium ;imparts more springiness and longevity than stainless steel. • V-shaped plastic tines to accommodate the wedge. • The tines have extra width that enables the ring to contact more tooth structure buccally and lingually.
Contact Forming Instruments • These are special instruments designed to create good contacts with posterior composites. • They push the matrix toward the contact area during light curing. • Eg: Contact Pro, Optra contact
Matrices for Class III Cavity Preparation
For amalgam ( S shaped matrix) • Ideal for Class III cavity prep on the distal of the cuspid with either a labial access or lingual access • Tofflemire used in case of incisal access Mirror handle used to produce the S shape in strip The band is contoured over the labial surface of the cuspid and lingual surface of adjacent bicuspid It is then placed interproximally and wedged apical to the gingival margin and covered with compound over facial and lingual ends
For direct tooth coloured restorations • Transparent plastic matrix strips • Length of strip should just be sufficient to cover the labial and lingual surface • A wedge is trimmed and applied to hold the strip in place
Matrix for two small proximal preparations in contact with each other • Loop formed in strip. It is flattened and creased with a finger, making a T shape and trimmed
Matrices for Class IV Cavity Preparation
• Plastic strip with inciso-proximal cavities
Transparent crown form matrices • These are ‘stock’plastic crowns, which can be adapted to tooth anatomy. • In bilateral class IV preparations use the entire crown form but in a unilateral class IV cut the plastic crown incisogingivally into two halves and use only the side corresponding to the location of the preparation • Should be perforated at the incisal angle. • The prepared tooth is partially filled with the restorative material while the matrix is completely filled • filled
Anatomic matrix • Prior to preparing the tooth, study model for the affected tooth together with atleast 1 intact adjacent tooth is made • Preferred especially in multiple teeth
Matrices for Class V Cavity Preparation
Anatomic matrix Window matrix •Formed using either tofflemire matrix or copper band matrix •Window is cut in the band slightly smaller than cavity outline •Usually not indicated for very wide cavities, occlusogingivally or mesiodistally
Cervical matrix •Different sizes and can be utilized with light cure restorations. •A handle is also provided to hold the matrix in place till the material sets
REFERENCES • Operative Dentistry – MA Marzouk • Art & science of operative Dentistry – Sturdevants (7th edition) • Textbook Of Operative Dentistry – Vimal K Sikri (3rd Edition) • Fundamentals of Operative Dentistry- Summitt's 4th ed. • Clinical Operative Dentistry- Ramya Raghu 2nd ed.
THANK THANK YOU FOR LISTENING

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Matrices

  • 1.
    Tooth seperation andMatricing Presenter：Dr. Sheetal Kotni
  • 2.
    1. Seperators 3.Matrices • Matrices for Class III cavity prep: • S shaped matrix • Transparent strips Matrices for Class IV cavity prep: • L shaped matrix • Transparent crown forms • Anatomic matrix Matrices for Class V cavity prep: • Window matrix • Cervical matrix • Anatomic matrix Matrices for Class III, IV, V cavity prep: • Bioclear • Unica • Introduction • Functions • Reasons for seperation • Principles of tooth movement • Types of seperators • Introduction • Definitions • Ideal requirements • Objectives • Parts • Classification • General priniciples of placement and removal 2. Wedges • Introduction • Ideal requirements • Classification • Wedge placement • Techniques of wedging • Recent advances:  Wedgeguards  Anatomic wedges  Elastic wedges Matrices for Class I cavity prep: • Barton matrix Matrices for Class II cavity prep: • Universal tofflemire • Omnimatrix • Slick bands • Contouring of the matrix band • Ivory 1, 8 • Black's matrices • Steele's siqveland matrix • Compound supported matrix • Copper band matrix • T band matrix • Automatrix and modifications • Reel matrix • Pinch matrix • Sectional matrices  Method  Contact rings  Classification, • Contact forming instruments CONTENTS
  • 3.
    1 3 2 Tooth movement isthe act of either seperating the involved teeth from each other, bringing them closer to each other and or changing their spatial position in one/more dimensions INTRODUCTION To facilitate the creation of physiologically functional contact, contour and occluding anatomy in the restored teeth Function Diagnosis of proximal caries, Reposition drifted teeth, matrix placement, polishing restoration,remove the foreign bodies impacted proximally Reasons for seperation 1 SEPERATORS
  • 4.
    Principal methods oftooth movement Rapid/immediate tooth movement Wedge principle:Elliot seperator, wedges Traction principle:Non interfering true seperator, Ferrier double bow seperator Slow or delayed tooth movement Rubber dam sheet Seperating rubberband Seperating ligature wires Oversized resin Temporary crowns Orthodontic appliances
  • 5.
    Rapid tooth movement: Mechanicaltype of seperation that creates either proximal seperation at the point of seperator's introduction or improved closeness of the proximal surface opp. the point of operator's introduction Wedge method: More the wedge moves facially or lingually when placed proximally, more the seperation Wedges Elliot seperator Indications: For short duration seperation that doesnt necessitate stabilization Examining proximal surface and final polishing of restored contacts Tooth seperation should not exceed 0.2- 0.5mm else damage and tenderness to pdl
  • 6.
    • Adjust thetwo opposite wedges of the seperator interproximally so that they are positioned gingival to contact area not impinging on interdental papillae or interceptal rubber dam. Move the knob clockwise so that the wedges move towards each other establishing desired seperation
  • 7.
    Traction principle Non interferingtrue seperator Indicated when continuous stabilized separation is required during the dental operation. Pros: separation can be increased or decreased after stabilization, non- interfering Ferrier double bow seperator The separation is stabilized throughout the operation. Pros- separation is shared by the contacting teeth, and not at the expense of one tooth, as with the previous type of instrument Always done with mechanical device which engage the proximal surfaces of the teeth to be seperated by means of holding arms. These are mechanically moved apart, creating seperation between clumped teeth
  • 8.
    Slow(delayed) tooth movement Rubberdam sheet Seperating rubber band Seperating wires Oversized resin temporary crowns Orthodontics appliances A small piece of heavy or extra heavy rubber dam sheet can be stretched and positioned in the contact area Thin pieces of wires are introduced beneath the contact area to form a loop around the contact area. The two ends can be twisted together to create a seperation not beyond 0.5mm. Oversized mesiodistally and periodically resin is added in the contact areas to increase the amount of seperation Most effective and predictable Used only when extensive respositioning is required The wires can be tightened periodically to increase the seperation Indication: When teeth have drifted considerably, rapid movement of teeth will endanger the pdl.Therefore,slow tooth movement, over a period of weeks, will allow the proper positioning of teeth in a physiological.
  • 10.
    2 Wedges Devices which createrapid seperation of teeth during preparation and restoration Commonly used to prevent overhangs at the proximal area which is an iatrogenic cause of periodontal pathology
  • 11.
    Ideal requirements • Easyto apply and withdraw • Shaped to minimize the risk of trauma to gingival and periodontal tissues • Supplied in range of shapes and sticks • Shaped to facilitate the restoration of proximal contours so that the deformation of matrix band does not occur • Disposable • Radiopaque • Rigid • Non toxic, non irritant • Stable in oral fluids • Not fracture • Available in bright colours
  • 12.
    Classification of wedges •Long/short • Hard/soft • Rigid/compressible • Wooden/plastic • Medicated/non medicated • Round/anatomic • Prefabricated/customized • Reflecting/non reflecting
  • 18.
    Palodent plus wedgeguard/ fender wedges • Isolation and protection during restorative treatment • Matrix and wedge in one step, fast adaptation even in the most complicated interproximal spaces. Easy to use, control and removal for the fabrication of Dental restorations. • Available in 3 different colour coded sizes. Contains 50 units. • Inserted into the inter dental space it provides a protector for the tissue and separates the teeth, simplifying the following application of a matrix. • Can be applied buccally or lingually for optimal access and vision.
  • 19.
  • 20.
    Elastic wedges • Forrubber dam placement and isolation • Autoclavable • Mostly used in tight contact cases
  • 21.
    3 Introduction 1. Class Icavity: No need of matricing due to confining walls 2. Matrices: Establish a temporary wall for the restoration when one or more walls of tooth are missing 3. The word matrix is derived from the Latin word Mater’ which means Mother. It was introduced in the year 1871 by Dr. Louis Jack MATRICES
  • 22.
    Definitions 1. isthe procedure, whereby a temporary wall is created opposite to axial walls and surrounding areas of tooth structure that were lost during preparation 2. is a device used during restorative procedures to hold the plastic restorative material within the tooth while it is setting.
  • 23.
    Ideal requirements 1. Easeof application 2. Not be cumbersome: for restoration condensation or patient comfort 3. Ease of removal after hardening of restoration 4. Rigidity: To confine the restorative material during condensation without displacement 5. Versatile enough to provide proper contact and contour in various situations 6. Positive proximal pressure against the tooth during restoration insertion 7. Non-reactive 8. Inexpensive
  • 24.
    Objectives • It mustact as a temporary wall of resistance during introduction of the restorative material. • It should provide shape to the restoration. • It should confine the restoration within acceptable physiological limits. • It must assist in isolating the gingiva and rubber dam during introduction of the restorative material • It must help in maintaining the dry operative field thereby preventing contamination of the restoration.
  • 25.
    Parts 1. Band: Pieceof metal or polymeric material used to support and give form to the restorative material during its insertion and hardening. e.g. cellophane, celluloid, mylar. Available as strips of various dimensions: 0.001-0.002 inch thickness 3/16 inch, 1/4 inch, 5/16 inch width 2. Retainer: Device by which the band can be maintained in its designated position and shape. e.g Mechanical device, dental floss, metal ring or impression compound
  • 26.
    1. Custom-made or anatomicmatrix. e.g Compound matrix 2. Mechanical matrix e.g Ivory 1, 8, Tofflemire Depending on its prep 1. Stainless steel 2. Copper band 3. Cellophane (cellulose acetate) 4. Polyacetate (mylar) Depending on the type of band material 1. With retainer e.g. Tofflemire, Ivory 1, 8, Steele's Siqveland matrix, Sectional matrix 2. Without retainer e.g. Automatrix, Copper band, Al band, Black's matrices, Anatomic matrix, S shaped , T shaped, L shaped matrix, Depending on the mode of retention 1. Class I cavity with buccal or lingual extension 2. Class II cavity 3. Class III cavity 4. Class IV cavity 5. Class V cavity Depending on the cavity preparation for which it is used Classification
  • 27.
    Class I cavitywith buccal or lingual extension E.g Double banded tofflemire matrix Class II cavity • Single banded tofflemire • Ivory 1, Ivory 8 • Compound Supported matrix • Copper band, T band, precontoured matrices • Automatrix Class III cavity • S Shaped matrix • Cellophane strips • Mylar strips Class IV cavity • Cellophane strips • Transparent celluloid crown forms • Dead soft metal matrix strips Class V cavity • Window matrix • Tin foil matrix • Preformed transparent cervical matrix Depending on the cavity preparation for which it is used
  • 28.
    Matrices Patented/Non- patented Patented All matrix with retainer Non-patented Youyourself modify for a particular clinical situation Circumferential/ Unilateral Circumferential Ivory 8, Steele's Siqveland Matrix, Tofflemire Unilateral Ivory 1, Sectional matrix
  • 29.
  • 30.
    GENERAL PRINCIPLES OFPLACEMENT AND REMOVAL OF MATRIX SYSTEMS Check for contacts, contours Pre-wedging if required in case of tight contacts Selection of matrix system Contouring of band Placement of matrix system Wedge placement, Support with compound if required Inspection of proper placement Restoration of cavity Removal of compound, wedge, matrix Check for contact, contours clinically, radiographically
  • 31.
    Matrices for ClassI Cavity Preparation
  • 32.
    Indication; Class I cavity withbuccal or palatal extension Since the tofflemire retainer with band doesn't intimately adapt to lingual groove- land sliding Stainless steel matrix (0.05 mm thick and 8 mm wide) between the lingual surface and the band already in place • A quick setting, rigid polyvinyl siloxane (PVS)–based material/ • Green stick compound/ • The end of a toothpick wedge is covered with softened (heated) compound may be used between the sectional matrix and the Tofflemire matrix band, to prevent lingual displacement of the sectional matrix during condensation Double Banded Tofflemire Matrix or Barton matrix
  • 34.
    Matrices for ClassII Cavity Preparation
  • 35.
    Universal Tofflemire Matrix •Navy dentist, Dr. Benjamin Franklin Tofflemire, 1946 • Made universal by the easy application and removal of the holder from the band without disturbing the condensed material • The retainer can be removed without the band-more pt. comfort • Helps to hold the cotton roll in place
  • 36.
    • Head isdirected gingivally • Set screw (1), rotating spindle (2), slide (3), head (4), band (5). • The slide is positioned near the head for installation of the band in the retainer and for placement of band around tooth • Rotating spindle/ vice moving nut adjusts the distance between the slide and the head. This movement adjusts the size of the loop • Set screw/ vice screw nut locks and unlocks the matrix band
  • 37.
    • The junction bw retainerand band should always be next to intact tooth surface for stability and prevention of unnecessary restorative material accumulation
  • 39.
    Tofflemire bands Ac to thickness Ultrathin:0.001 inch Thin: 0.0015 inch Medium: 0.0020 inch Flat bands of multiple shapes Precontoured bands-little or no adjustment Larger circumference - occlusal edge Smaller circumference- gingival edge
  • 40.
    Contouring of thematrix band Outside the patient mouth Inside the patient mouth Band should be placed on a resilient paper pad because contouring cannot occur on a non resilient surface After placing the band and retainer, the band is burnished against the adjacent tooth with burnisher Used with firm pressure in back and forth overlapping strokes The convex side of a spoon excavator imparts a convex contour to the matrix band
  • 41.
    2 thicknesses of metal bands: .0015”, ultrathin .001” Preassembled and disposable tofflemire retainer and band Less time consuming Single piece, plastic lightweight retainer with .002” mylar/metal bands Winged or wingless Expensive Omnimatrix Pivoting head Simply adjust the band's circumference by twisting the conical handle.
  • 42.
    • Proprietary non-stickSlick Bands™ technology • Improved tear-resistant dead-soft matrices Slick Bands™ Tofflemire-Style Kit
  • 43.
    Ivory No. 1,8 Ivory 1 Ivory 8 Stainless steel band encircles one proximal surface of posterior tooth Encircles entire crown of the tooth • Indicated in unilateral class 2 cavities • Tight distal contact Indicated in Unilateral/bilateral Class II(MOD) of posterior teeth Band attached to the retainer with a wedge shaped projection which engages the tooth at the embrasure of unprepared surface Cumbersome to place Molar Premolar
  • 44.
    BLACK'S MATRICES STEELE'SSIQVELAND MATRIX G. V. Black, 1900 The matrix consists of a circumferential band with a thumbscrew retainer Recommended for majority of small and medium sized cavities Indicated for restorations of three or more surfaces Black's matrix with a gingival extension: to cover the gingival margin of a subgingival cavity, a wire/floss is tied to the band to prevent slippage and tied around the tooth
  • 45.
    Compound supported Matrix system Shapeof matrix after trimming Contouring Burnishing Placement, wedging, compund support with cone Contour altered by warm burnishing instrument
  • 46.
    Copper band matrix •Band stabilized with low fusing compound, pushed against the adjacent tooth • After carving, cut on b/l and then remove
  • 47.
    T BAND MATRIX •T shaped band • When formed, the top portion of the T allows the straight portion to adjust and fit the circumference • Curved/straight • Narrow/wide • Brass/steel • The band is held in place with a flexible metal ring: contact ring, placed with special forceps and stabilizes the ends of matrix band snugly
  • 48.
  • 49.
  • 50.
    Modifications of automatrix •Metal Dental Bands Retainerless Universal Supermat Automatrix
  • 51.
  • 52.
    Pinch matrix: Pinchtowards tooth for tension • Introduced by Kerr • For Class II MO/OD/MOD composite fillings in posterior area with the innovative integrated opening system. • The ring matrix band is 0.038 mm for stable placement without distortion through tight intact contact points. • Three sizes • Excellent patient comfort and better visibility of the working area.
  • 53.
    SECTIONAL MATRIX ANDCONTACT RING • KHB
  • 54.
    • The sectionalmatrix system and separation rings are made up of nickel-titanium alloy to create a consistent force to separate teeth and then return to their original shape after use, helping to deliver a tight gingival seal and anatomically shaped restoration. Precontoured bands of different dimensions G ring/ bitine rings
  • 55.
    • D Place amatrix band that most closely approximates the occluso-gingival height of the tooth. The band should be oriented with concave edge towards the occlusal margin of the tooth. Insert wedge Apply the 3D –ring retainer. Hold the ring retainer with the ring placement forcep and place it over the wedge. Burnish the band in the desired contact area against the adjacent tooth and make sure there is no springback of the band Restore the cavity as desired. Remove the ring, wedge and band. Removal of the ring and band may require the need of forcep
  • 56.
    • First reportof a contoured sectional matrix: Meyer • Concept based on the MCKean orthodontic seperator is the surest method of achieving good contacts • Two equal and opposite forces cause seperation of teeth: McKean principle
  • 57.
    Contact rings • Accordingto their evolution, categorized as First generation systems Second-generation systems • First generation systems Introduced in the late 1990s Include :- • Palodent Bitine • Contact matrix • Composi-Tight
  • 58.
    Palodent BiTine Iand BiTine II • First system that was available. • Rings have rectangular parallel tines. • Optimum separation (0.55 kg/mm). • Lack of retentive design because of the parallel tines but are easy to place on wide preparations. • BiTine II is an elongated ring to allow stacking over the main ring in case of MOD preparations
  • 59.
    Contact matrix • Theserings have rectangular tines which are converging and hence are more retentive. • Provide optimum separation (0.38 kg/mm). • A reverse ring is available for MOD preparations.
  • 60.
    Composi-Tight matrix • Twoseparate rings are available for premolar and molar teeth. • The rings have converging tines with retentive balls at the end for firmer grip on the teeth. • Omnidirectional. • Drawback: Contacts produced are not so tight (0.27 kg/mm). • Large diameter of the rings can lead to their collapse if used in wide cavities
  • 61.
    Problems with earlycontact rings • Ring collapse or displacement in case of wide proximal boxes. • Ring stacking that is, placing one ring over the other in case of MOD restoration is a problem. • Most importantly, since the contact rings are made of stainless steel, repeated usage and sterilization effects make them lose their springiness over time
  • 62.
    Second - GenerationRings Composi-Tight 3D soft face ring system The orange Soft Face 3D-Ring The gray thin tine G-Ring • Used in most circumstances • Ease of placement • Burnished tine ends Ability to adapt to a wide variety of tooth anatomies while reducing flash and restoring proper contour Used where the shape of the dentition makes ring retention more problematic
  • 63.
    V3 ring system Dr.Simon McDonald in 2008 2 types of rings for bicuspid and molar teeth • Precontoured matrix bands • Special wedge called the ''wave wedge''to provide optimum gingival adaptation of the matrix band. It has two major innovations • Fully made of Nickel-Titanium ;imparts more springiness and longevity than stainless steel. • V-shaped plastic tines to accommodate the wedge. • The tines have extra width that enables the ring to contact more tooth structure buccally and lingually.
  • 64.
    Contact Forming Instruments •These are special instruments designed to create good contacts with posterior composites. • They push the matrix toward the contact area during light curing. • Eg: Contact Pro, Optra contact
  • 65.
    Matrices for ClassIII Cavity Preparation
  • 66.
    For amalgam (S shaped matrix) • Ideal for Class III cavity prep on the distal of the cuspid with either a labial access or lingual access • Tofflemire used in case of incisal access Mirror handle used to produce the S shape in strip The band is contoured over the labial surface of the cuspid and lingual surface of adjacent bicuspid It is then placed interproximally and wedged apical to the gingival margin and covered with compound over facial and lingual ends
  • 67.
    For direct toothcoloured restorations • Transparent plastic matrix strips • Length of strip should just be sufficient to cover the labial and lingual surface • A wedge is trimmed and applied to hold the strip in place
  • 68.
    Matrix for twosmall proximal preparations in contact with each other • Loop formed in strip. It is flattened and creased with a finger, making a T shape and trimmed
  • 69.
    Matrices for ClassIV Cavity Preparation
  • 70.
    • Plastic stripwith inciso-proximal cavities
  • 71.
    Transparent crown formmatrices • These are ‘stock’plastic crowns, which can be adapted to tooth anatomy. • In bilateral class IV preparations use the entire crown form but in a unilateral class IV cut the plastic crown incisogingivally into two halves and use only the side corresponding to the location of the preparation • Should be perforated at the incisal angle. • The prepared tooth is partially filled with the restorative material while the matrix is completely filled • filled
  • 72.
    Anatomic matrix • Priorto preparing the tooth, study model for the affected tooth together with atleast 1 intact adjacent tooth is made • Preferred especially in multiple teeth
  • 73.
    Matrices for ClassV Cavity Preparation
  • 74.
    Anatomic matrix Window matrix •Formedusing either tofflemire matrix or copper band matrix •Window is cut in the band slightly smaller than cavity outline •Usually not indicated for very wide cavities, occlusogingivally or mesiodistally
  • 75.
    Cervical matrix •Different sizesand can be utilized with light cure restorations. •A handle is also provided to hold the matrix in place till the material sets
  • 80.
    REFERENCES • Operative Dentistry– MA Marzouk • Art & science of operative Dentistry – Sturdevants (7th edition) • Textbook Of Operative Dentistry – Vimal K Sikri (3rd Edition) • Fundamentals of Operative Dentistry- Summitt's 4th ed. • Clinical Operative Dentistry- Ramya Raghu 2nd ed.
  • 81.

Editor's Notes

  • #13 haemo wedges
  • #39  few techniques to remove the Tofflemire matrix without breaking the marginal ridge: • As the matrix edge is coming out of the contact, the matrix can be tipped so that the edge will not “flip” the newly carved marginal ridge and break it. • A condenser can be held against the marginal ridge to support it and prevent it from breaking as the matrix is removed. • The movement of the band should be primarily to the facial or lingual aspect as the band slips occlusally out of the contact.
  • #40  Getz Contour Matrix Band or Dixieland Band (Waterpik Technologies) developed by Dr Wilmer Eames-precontoured bands