PROXIMAL CONTACTS AND CONTOURS 1.ppt

1. PROXIMAL CONTACTS AND
CONTOURS

2. CONTENTS
• Contacts and contours of teeth that are tapering, ovoid
and square.
• Marginal ridges.
• Proximal contact areas
• Interproximal space
• Embrasures
• Contact areas and occlusal embrasures from the buccal
and labial aspect of maxillary and mandibular teeth
• Hazards of faulty reproduction of physioanatomical
features of teeth
• Procedures for formulation of proper contacts and
contours.
• Wedges
• Matrices
• Contacts in centric occlusion
• Conclusion

3. INTRODUCTION
• From the cariogenic aspect there may be only twenty
occlusal surfaces but there are sixty contacting
proximal and sixty four facial and lingual surfaces that
are susceptible to decay in the full complement of
teeth decay on the proximal however, occurs mainly
due to the faulty interrelationship between the contact
areas, the marginal ridges, the embrasures, and the
gingiva.
• According to their general shape, teeth can be
divided into three types, with each having its own
physical characteristics in the contact area and
related structures. The area of the mesial or distal
surface of a tooth which touches its neighbor in the
arch is called the contact area.

4. • 1. Tapering teeth.
• In an inciso apical direction contacts of
tapered maxillary central and lateral incisors
start incisally near the incisal edges. In a
labiolingual direction they start slightly labial to
incisal edges.
• Tapered cuspids are very angular, with mesial
contact area close to incisal edges and distal
contact area near the centre of distal surface.
• The tapering type of bicuspid is also angular,
possessing crowns, constricted cervically and
with long cusps.
• As those cusps taper lingually, the contact
areas occur bucally starting almost at the
buccal axial angle of the tooth.

5. • Since all these contact begin approximately 1mm
gingivally from the crest of the marginal ridges,
the bicuspids contacts of this type of tooth will be
found just gingival from the junction of the
occlusal and the middle third of the crown.
• Mesial contacts of tapered molars approach the
mesiobuccal axial angle of the tooth in a bucco
lingual direction and from one third to, one half
the distances from the occlusal surface to the
cemento-enamel junction of the tooth occluso-
gingivally.
• Lingual shifting of the contacts is more noticeable
in mandibular than in maxillary molars.

6. • No definite position can be set for the mesial
contacts of the tapered mandibular second
molars and distal contacts of the approximately
first molar, owing to the fact that the third buccal
cusp of the first molar presents many variables in
contour and position.
• The proximal contour of the tapering type teeth
has one common feature starting at the cemento-
enamel junction,the surface presents concavity
almost to the contact areas, and they are
decidedly convex from there to the crest of the
marginal ridges.
• Concavities occur most frequently on the mesial
surfaces of teeth having buccal and lingual roots,
the most pronounced being the mesial of the
upper first premolar.

7. • 2. Square type teeth
• This type of tooth is bulky and angular, with little
rounded contour. Since there is little cervical
constriction, their proximal surfaces are almost
devoid of curves.
• The incisal contacts are in a line with the incisal
edges labiolingually and extend almost to
incisal angle incisally. These teeth are
frequently in contact with their neighbour in a
place instead of point, which varies from .5
to.3mm.
• Cuspid contacts are relatively close to the
incisal edges and in line with them
labiolingually.

8. • The posterior contacts are broad areas on square type of
teeth. Since the teeth have relatively short cusps,the
occlusal limit of the posterior contacts will be found in
occlusal one third of the crown.
• The configuration of the bicuspids and molars places the
buccal extent of the contact well into the buccal one
third.

9. • Mesial contacts are nearer the buccal axial angle
than the distal. Mesial contacts of mandibular
molars may measure from lmm-4mm
buccolingually and be from a mere line contact to
including half the height of the crown
occlusogingivally. Contacts originate in the
bucco-occlusal section of the crown.
• The distal contacts originate more lingually.
Incisal, labial, occlusal and buccal embrasures
are almost nil.
• The lingual extent of the contact of maxillary
molars usually stops in the middle one third while
while the gingival extent is seldom more than
1mm from the cementoenamel junction.

10. • The gingival embrasures maybe barely noticeable or may
extend about l/3rd of the height of the crown. When the
buccal embrasures are present, they are very narrow and
flat.
• The lingual embrasures maybe narrow or wide in their
bucco-lingual extension but they are always narrow
mesio-distally.
• The proximal contours of square type teeth have a
tendency to become a plane instead of a curved surface.
• Buccolingual concavities are found occasionally on the
mesial surfaces of maxillary first bicuspids, first and
second molars, and the mesial surface of the mandibular
first molar.
• The distal surfaces are generally either flat or slightly
convex from the buccal or lingual surface. The convexity
that creates the marginal ridges disappears at the contact
and the remainder of the surface in the gingival direction
is usually flat.

11. • 3. Ovoid type teeth
• The ovoid type tooth is a transitional type
between the tapering and square types. Its
surfaces are primarily convex but infrequently
they become concave.
• In an inciso -gingival direction the mesial
contacts of the incisors start at about l4th the
height of the crown from the incisal edges. In a
labiolingual direction they start slightly lingual to
the mesial edges.
• The distal contacts of the incisors have the
same labio-lingual position,but may be found
from l3rd to half the height of the crown from
the incisal edge in an inciso gingival direction.
• In molars, the prominence of the mesiobuccal
cusp, coupled with the buccolingual convexity,
places the buccal extent of the mesial contacts
at the junction of the buccal and middle thirds of
the crown.

12. • The labial, incisal and buccal embrasures of
ovoid teeth are larger and more extensive than
those found in other types.
• Gingival embrasures are relatively short occluso-
gingivally and broad mesio-distally at their bases.
Lingual embrasures are comparatively short
labio- lingually and broad mesio- distally.
• Proximal contours of ovoid anterior teeth are
decidedly convex from the incisal angle to the
cervix.
• Bicuspids of ovoid teeth are frequently bell
shaped with the convex surface running from
crests of marginal ridges almost to the cervix
where they merge via a slightly concave surface
to a union with the root surfaces.

13. • The bicuspids are likewise convex from
the buccal to axial angles.
• The mesial surfaces of ovoid molars
present convex areas that are less
extensive than those found distal surfaces.
• Generally there is a tendency in all three
types of teeth for the distal contacts to
move in a lingual direction, progressing
further back in the arch.

14. • Marginal Ridges
• These are rounded borders of enamel that form the
form the mesial and distal margins of occlusal
surfaces of premolars and molars and mesial and
distal margins of lingual surfaces of incisor and
canines.
• A marginal ridge should always be found in two
planes, meeting at a very obtuse angle. This feature is
essential when an opposing functional cusp occludes
with the marginal ridge.
• A marginal ridge with these specifications is essential
for the balance of the tooth in the arch, the prevention
of food impaction proximally, the protection of
periodontium, the prevention of recurrent and contact
decay and for helping in efficient mastication.

15. • Proximal Contact Area.
• It's the term used to denote the area of proximal height of
contour of the mesial or distal surface of a tooth that
contacts its adjacent tooth in the same arch.
• When the teeth erupt to make proximal contact with
previously erupted teeth, there is initially a contact point.
The contact point becomes an area due to wear of one
proximal surface against another during physiologic tooth
movement.
• The proper contact relation between neighboring teeth in
each arch is important for the following reasons.
• It serves to keep food from packing between the teeth,
and it helps to stabilize the dental arches by the combined
anchorage of all the teeth in either arch in positive contact
with each other.
• Food impaction as a result of improper contacts can result
in periodontal disease carious lesion and possible
movement of teeth.

16. • In addition, the retention of food is
objectionable by its physical presence and
halitosis that results from food
decomposition.
• The proximal contacts along with interdigitation of
teeth through occlusal contacts stabilizes and
maintains the integrity of the dental arches.
• The proximal contact area is located in the incisal
third of the approximating surfaces of the
maxillary and mandibular central incisors. It is
positioned slightly facial to the center of the
proximal surface faciolingually.

17. • Proceeding posteriorly from the incisor region
through all the remaining teeth the contact area
is located near the junction of the middle and the
incisal third or in the middle third.
• Because of these contacts being positioned
progressively lower cervically larger incisal or
occlusal embrasures result. Properly located
proximal contacts promote normal healthy
interdental papillae.

18. • Interproximal space (Formed by proximal
surfaces in contact).
• The interproximal spaces between the teeth are
triangularly shaped spaces normally filled papillae
by gingival papillae.
• The base of the triangle is the alveolar process;
the sides of the triangle are the proximal surfaces
of the contacting teeth, and the apex of the
triangle is the area of contact.
• The form of the interproximal space will vary with
the form of the teeth in contact and will also
depend upon the relative position of the contact
areas. There is normally a separation of 1-1.5mm
between the enamel and the alveolar bone.

19. • Proper contact and alignment of adjoining teeth
will allow proper spacing between them for the
normal bulk of gingival tissue attached to the
bone and teeth.
• The type of tooth also has a bearing upon the
interproximal space. Some individuals have
teeth that are wide at cervices, constricting the
space at the base. Others have teeth that are
more slender at the cervices than usual. This
type of tooth widens the space.

20. • Embrasures (spill ways)
• Embrasures are V shaped spaces that originate
at the proximal contact areas between adjacent
teeth and are named for the direction toward
which they radiate.
• These embrasures are 1) facial 2) lingual 3)
incisal or occlusal 4) gingival.
• Initially the interdental papilla fills the gingival
embrasure. In a mouth where ideal tooth form
and function are ideal and optimal oral health is
maintained, the interdental papillae may continue
in position through out life.
• When the gingival embrasure is filled by papilla ,
the trapping of food in this region is prevented.

21. • In a faciolingual longitudinal section
direction the papilla may be triangular
between anterior teeth, where as in the
posterior teeth the papilla may be shaped
like a mountain range, with facial and
lingual peaks and the col lying between the
contact area.
• This concave area beneath the contact ,is
more vulnerable to periodontal disease
from incorrect contact and embrasure form
because it is covered by nonkeratinized
epithelium.

22. • Contact areas and incisal occlusal embrasures from
the buccal and labial aspect
• Maxillary teeth Central incisors.
• The contact areas mesially on both central incisors are
located at the incisal third of the crowns.
• Since the mesio incisal third of these approaches a right
angle, the incisal embrasure is very slight.
• Central and lateral incisors.
• The distal outline of central incisor crown is rounded .
• The lateral incisor has a shorter crown and has a more
rounded mesio-incisal angle than the central incisor.
• The form of these teeth coming into contact with each
other, therefore opens up an embrasure space distal to
the central incisor larger than the small one mesial to the
central incisors.

23. • Canine and First Premolar.
• The canine has a large distal slope to its cusp,
which puts the distal crest of the curvature at the
center of the middle third of the crown.
• The first premolar has a long cusp form also,
which puts its mesial contact area rather high
upon the crown cervical to the junction of the
occlusal and middle thirds). The embrasure
between the teeth has a wide angle.
• First and second premolar.
• The contact areas of these teeth are usually a
little cervical to the junction of the occlusal and
middle third of the crowns. The form of these
teeth creates a wide occlusal embrasure.

24. • Second Pre Molar and First Molar
• The position of the contact areas cervico
occlusally is about the same as that found
between the premolars.
• First and Second and Third molars
• The distal out line of the first molar is round a fact
that puts the contact area approximately at the
center of the middle third of the crown.
• The mesial contact area of the second molar also
approaches the middle third of the crown.
• The contact and embrasure design of the second
and third molars is similar to those of the first and
second molars.

25. • MANDIBULAR TEETH
• Central incisors:
• The mesial contact areas on the mandibular
central incisors areas on the mandibular central
incisors are located at the incisal thirds of the
crowns.the contact areas extend to the
mesioincisal angle.
• Central and lateral incisors.
• The distal contact areas and the incisal
embrasures on the central incisors and the
mesial contact areas and incisal embrasures on
the lateral incisors are similar to the central
incisors.

26. • Lateral incisors and canine.
• The positions of contact areas distally on the
lateral incisor and mesially on the canine are
cervicoincisal. The mesioincisal angle of the
canine is more rounded the others, which form
opens up a small incisal embrasure at this point.
• Canine and first premolar.
• The distal slope of the cusp of the mandibular
canine is pronounced and long which places the
distal contact area on this tooth somewhere
cervical to the junction of the incisal and middle
thirds.
• The first premolar has long buccal cusp. The
occlusal embrasure is quite wide and pronounced
because of the cusp forms of the two teeth.

27. • First and Second Premolars.
• The buccal cusp of the second premolars
is not as long as that of the first premolar.
• The contact of these teeth is nearly the
level with that of the canine and first
premolar.The slope of the cusps create a
large occlusal embrasure.

28. • Second Premolar and First Molar.
• The contact and embrasure design for these
teeth is similar to that of the premolars.
• First Second and Third Molars.
• The proximal surfaces are quite round;the distal
surface of the first molar, mesial surface of the
second molar, distal surface of second molar and
mesial surface of the third molar. The occlusal
embrasures are, therefore, generous above the
points of contact even though the cusps are short
and rounded.

29. • Facial and Lingual Contours and Related Structures
• In a vertical direction, all tooth crowns will exhibit some
convex curvatures occlusal the cervical line. This
curvature is sometimes called the cervical ridge.
• In any mouth the average curvature will be about
0.5mm or less. Mandibular posterior will have a lingual
curvature of approximately 1mm, with the crest of
curvature at the middle third of the crown which is
caused by the lingual inclination of these teeth.
• Its not uncommon for maxillary posterior teeth to have
similar curvature on the lingual aspects especially when
the buccal inclinations are less than normal.
• Mandibular anterior teeth will have less curvature on
the crown above the cervical line than any other teeth.
• Usually its less than 0.5mm and occasionally it is so
slight that it’s hardly distinguishable.

30. • The incisal one half to two thirds of the lingual
surfaces of anterior teeth displays some
concavities, a feature more pronounced with
upper central and lateral incisors.
• These concavities are less pronounced than in
lower central and lateral incisors and least
pronounced in cuspids.
• For upper anterior teeth the concavities are an
essential anterior determinant for mandibular
movement.
• In posterior teeth there will be mesiodistal
convexity corresponding to each cusp in
anatomical crown portion of the teeth.
• The convexity on the facial and lingual areas
decrease in magnitude as we approach the
cemento enamel junction.

31. • At the cemento enamel junction, or slightly
occlusal to it, the facial or the lingual surface will
flatten or become concave, especially if the
crown surface joins a bifurcation.
• In the anterior teeth, the entire labial surface will
have a pronounced convexity mesio distally.
• The magnitude of this convexity increases
gradually from the incisal ridge apically, reaching
its maximum just incisal to the cemento enamel
junction, gingival line decreases almost to a flat
surface as cemento enamel junction.
• The lingual surface of an anterior tooth exhibits a
mesiodistal convexity only at its apical one third
to one half.

32. • From that point incisally its concave, completing
a dish shaped surface started by the incisal
guidance concavities.
• The proper mesio- distal contour at different
levels and locations of the facial and lingual
surfaces is vital for the health of the investing
periodontium.
• A comparison between the contour of teeth and
periodontium contour mesiodistally will reveal
that both contours should the same to ensure
physiologic movement of the structures and
materials.

33. • Hazards of faulty reproduction of
physioanatomiocal features of
teeth.
a) Contact size:
• l) Creating a very broad contact bucco
lingually or occluso gingivally, in addition
to changing the tooth anatomy will change
the anatomy of the interdental col.
• The normal saddle shaped area will
become broadened. The broadened
contact areas produce an interdental area
that the patient is less able to clean, i.e.
increases the susceptibility to future
decay.
• Microbial plaque develops more readily
and as a result the papillary area
becomes inflamed and edematous.

34. • Broadening the contact area leads to adhesion
of debris and possible intraproximal impaction of
the debris.
• Broadening the contact area could beat the
expense of the gingival embrasures, so that the
restoration could encroach physio- mechanically
on interdental periodontium predisposing to its
destruction.
• 2) Creating a contact area too narrow
buccolingually or occlusogingivaly will allow will
allow food to be impacted vertically on non
keratinized col area. This will lead to plaque
accumulation and predisposes for periodontal
disease and caries problems.

35. • 3) Contact area placed too occlusally
will result in flattened marginal ridge at
the expense of occlusal embrasures.
• 4) Contact area placed too bucally or
lingually will result in a flattened
restoration at the expense of buccal or
lingual embrasures.
• 5) A contact area placed too gingivally
will increase the depth of the occlusal
embrasures at the expense of the
contact areas own size or at the
expense of of broadening or impinging
upon the interdental col.

36. • 6) Open contact creates continuity of the embrasures
with each other and with the interdental col.
• This results in food impaction and accumulation of
bacterial plaques with periodontal and carious
problems.
• Therefore proper reproduction of size and location of
contact areas to imitate natural dentition is essential for
the success of the treatment and restoration of the
proximal surface.

37. • b) Contact configuration.
• If created flat can make it broad buccally, lingually,
occlusally and or gingivally.
• Contact area with excessive convexity will diminish the
contact area. This will predispose to periodontal
destruction and decay.
• The interlocking between concavity and adjacent
convexity can immobilize the contacting teeth, depriving
them of normal, stimulating physiological movements,
resulting in periodontitis or mechanical breakdown.
• In the restoration with a concave contact area,its
impossible to create the proper size of marginal ridge or
adjacent occlusal anatomy.

38. • c) Contour.
• Facial or lingual convexities.
• Over convex curvatures can create an undisturbed
environment for the accumulation and growth of
cariogenic and plaque ingredients at the gingival margin
apical to the height of contour. This deprives the free and
attached gingiva facially and or lingually from the
massaging-stimulation-keratinizing effect of the apical
components of food stream.

39. • 2) Facial and Lingual Concavities.
• Deficient or mislocated concavities will lead to
premature contacts during mandibular
movements ,which could inhibit the physiological
capabilities of the mandibular moments.
• Excessive concavities can cause extrusion,
rotation or tilting of occluding cuspal elements
into non physiologic relations with opposing teeth.
• Deficient concavities apical to the height of
contour can create restoration overhangs and
excessive concavities decrease the chance for
successive plaque control in these extremely
plaque retaining areas.

40. • Areas of proximal contour adjacent to contact .It
is essential to restore proper contour to that
portion of the proximal surface not involved in
contact .
• This would include areas occlusal buccal,
lingual, and gingival to the contact area.
• Fabricating a restoration that does not
reproduce the convexities and concavities which
occur here will lead to overhangs vertical and
horizontal impaction of debris and impingement
upon the adjacent periodontal structures.

41. • A contoured filling would
– Reestablish the proper form of the inter-
proximal space
– Maintain the function of the teeth
– Ensure no breach in the continuity of the
occlusal aspect of dentition
– Maintain the length of the arch
– Prevent impaction of food
– Maintain the health of the gingiva

42. Issues involved in establishing
contours
• For the proper reproduction of physio anatomical
features of teeth with a restorative material, tooth
movement and matricing must accompany or
precede restoration procedures
• There are two issues involved in establishing
contacts and contours
– MATRICING
– TOOTH SEPARATION

43. DEFINITION
• Matrix first introduced by Louis Jack
(1971) from Latin word ‘Mater’ meaning
‘mother’.
• Matrix is a device used to contour a
restoration by providing a temporary wall
to stimulate that of a tooth structure, which
it is replacing.

44. • Wedges are wedge shaped devices which
are snugly inserted into the gingival
embrasures, so as to close any gap at the
gingival margin after tightening of the band
and to create space between teeth.

45. MATRICING

46. Matricing is the procedure whereby a temporary
wall is created opposite to the axial
walls,surrounding areas of tooth that were lost
during preparation
– Matrix- is essential for the proper reproduction
of the proximal, facial & Lingual anatomy in
any restoration of plastic nature

47. PARTS of a MATRIX SYSTEM
Matrix is formed of two part
• Band which is a piece of metal, celluloid or
polymeric material used to support and
give form to the restorative material during
its introduction and hardening.
• Retainer is a device by which the band can
be retained in its designated position and
shape. This could be a mechanical device,
a wire, dental floss and or compound.

48. IDEAL REQUISTES OF A
MATRIX
• Able to be easily inserted
• Be sufficiently rigid to retain the contours
given to it so that it can be transferred to the
restoration
• Should not adhere or react with restoration
material.
• Should resist the condensation pressure.
• Should attain proper proximal contact and
prevent gingival excess.
• it should be easily removed

49. OBJECTIVES
• Should act as a temporary wall of
resistance during introduction of the
restoration material.
• Should provide shape to the restoration
• Should confine the restoration within
acceptable physiological limits
• Must assist in isolating the gingiva and
rubber dam during introduction of
restoration material
• Help in maintaining dry operation field to
prevent contamination of rest material.

50. CLASSIFICATION
Based on mode of retention
• Mechanically retained matrices
• Self retained matrices

51. Based on transparency
• Non transparent matrices
• Transparent matrices
Based on the material
• Metallic
– Unilateral (Ash no.IX)
– Circumferential (Ivory no. 8,Tofflemire,
Bonnalie)
• Non-metallic

52. ORIGINAL MATRIX

53. HISTORICAL PERSPECTIVE
• First recorded use of a matrix was by
Dwinelle (1855) where he used a band
which was a broad, thin piece of dense
gold which was wedged firmly against the
tooth.
• It was open at cervical margins of cavity
prepared but his work was not recorded
• Later the original matrix which was a metal
band came into being.

54. IMPROVEMENTS ON
ORIGINAL MATRIX
• The concept of contoured fillings added
significance to the original matrix for which
improvised modifications were done.

55. JACK MATRIX
• Introduced in 1871 by
Jack
• First matrix to satisfy
to a certain extent the
concept of contoured
fillings.
• Band in assorted sizes
and shapes placed by
forceps and wedged
with a boxwood
wedge.

56. IMPROVED JACK MATRIX –
DEPRESSED MATRIX (Jack 1855)
• Band was thinner at
cervical aspect
• Curved from end to
end for more access
to the cavity
• Wedged with two
wedges of
orangewood – from
facial and lingual.

57. HUEY MATRIX (1874)
• Design included a
circumferential band
• Could be used for two
and three surface
restorations
• Consisted of a band of
flat, platinum plate No.
28. (American gauge),
which encircled the
tooth
• Holes at the ends to
accommodate a screw
with a nut.

58. PERRY MATIX
• Introduced in 1886
• Thin, narrow brass or
phosphor bronze band
• Band shaped before
placement
• Perry separator held the
band in place.
• If close adaptation at
cervical margin was
required, a wedge of
soft wood placed into
lingual embrasure.
1886 Brophy

59. Brunton Matrix (Hutchinsons
1885)
• This did not require
the adjacent tooth for
retention
• Band was made of
short piece of clock
spring with ends
sharply bent on
themselves

60. CUSTOM MATRICES

61. Custom matrices
• Consists of a band in conjunction with
some type of separating device other than
a mechanical separator.
Three types used currently
– Anatomic matrix
– Tie band matrix
- Continuous loop matrix

62. • Previously, the band wires were of
unspecified thickness
• Later custom matrices used thickness of
bands ranging from 0.001 – 0.002 in (25.51
m) and were made of German silver
copper, nickel, aluminum and steel (carbon
or stainless).
• Most of them were precontoured bands and
then shaped further after the matrix was
placed, wedged and stabilized with
compound.

63. ANATOMIC MATRICES
• Shellac Matrix (Jack
1887)
– First used shellac to
encompass the tooth
being operated
– Later along with shellac
a band was introduced
made of clock spring or
platinum foil which was
placed in the inter-
proximal area.

64. Herbst Matrix (Bernet 1885)
– Piece of clock spring extended around half
the tooth, covering and reaching beyond all
margins of the cavity.
– Later wedges one or two were included as
modifications and band of steel, thin German
silver or Brown’s polishing metal.

65. Hutchinson’s Matrix
• Hutchinson devised this in 1885
– Used a short length of a small blade of a
penknife
– Blade heated and bent and no wedge
required.

66. Hand matrix
• By Newikirk 1908
– Thin blade attached to and continuous with a
shank and handle
– Opposite edge of the blade placed against the
crown of the adjacent tooth
– Handle of the blade in the operators left hand.

67. Wood Ward Matrix
• (Wood Ward 1885)
– Polished band of steel
blank secured with
contoured wedges

68. Rubber Matrices
– Matrix consisted of rubber material
– Initially matrix made of vulcanized rubber
which was shaped on a model.

69. • Danforth Matrix (Danforth 1908)
– Rubber dam instead of vulcanized rubber
– Rubber dam piece was drawn taut around the
adjacent tooth.
• Adapto matrix – (F.C. Munch 1937)
– Rubber was used to achieve separation
– Proved unsatisfactory due to the elasticity of
the matrix which inhibited approximal
adaptation of the filling material.

70. Sweeney Matrix – (Sweeney
1940)
• Successor to the
custom matrices
– Steel or brass band and
un tempered steel band
were used and
supported by compound
– Further stabilized with
an ivory No.1 retainer
inserted into the
compound on facial and
lingual sides.

71. – Improvised technique for the placement of this
matrix was
– To establish the facio lingual contour in the
band with contouring pliers like Millers pliers
with leaded beaks or with an ovoid burnisher.

72. Ingraham – Koser Matrix (1955)
– Redesigned the Sweeney
matrix
– Contained band of
stainless steel 3/8 x 0.002
inch (9.5mm x 51m)
– Had a U shaped staple for
support
– Thin model facilitated the
placement of multiples
matrices as the staple
secured the compound.

73. Sectional Matrix with Bi Tine
Ring (Meyer 1957)
• Can be used to place both two surface
and 3 surface restorations
• Consists of a precontoured band of
stainless steel 0.0015inch (38m) thick
• Stabilized by Bi Tine Ring and compound
applied on its tined tips
• After placement the band is burnished with
a ball burnisher to perfect the contact and
contact area.

74. Open face matrix (Suret 1958)
• Band was wedged and then stabilized
with the index finger
– Was not widely used or popular

75. Using a Compound Matrix
• After the band is in place and the contour is
verified an appropriate wedge is placed
• Then soften a piece of low fusing compound in a
flame
• Shape into a cone
• Slightly glaze the base by a quick pass through
the edge of the flame

76. • Attach the base to the end of the
appropriate gloved forefinger
• Glaze the tip of the cone by passing it
through the side of the flame
• Immediately press the softened tip into the
embrasure where the wedge is placed

77. • See that some compound is extended against
the matrix and to adjacent tooth
• Now the same for the opposite side
• Compound cones can be prepared in advance
and stored for later use
• Make sure not to apply too much compound
making the matrix bulky and chances of
loosening due to tongue and cheek movements
• Sometimes the facial and lingual compond
surfaces are united occlusally with compound for
stability
• Do not release pressure against the strip until
the compound is cooled with an air syringe

78. Removal of Compound
• Break away the compound from the facial
and lingual surfaces with a stiff explorer
tine
• Carefully remove all the compound
remaining in the embrasures
• Then with No.110 pliers hold the band and
remove it from the surface opposite to the
surface the wedge was placed

79. TIE BAND MATRIX

80. • The early custom matrices that preceded
the tie-band matrix were
– Perry matrix
– Clap
– Fille Brown Matrix

81. Perry Matrix (Hams 1889)
• Consisted of a very thin band
of steel that extended around
half the tooth.
• Bands were of different sizes
and shapes and had holes at
the ends
• A cord of floss or silk thread
was passed through these
holes and tightened around
the tooth and wedged if
necessary.

82. CLAPP MATRIX (CLAPP 1897)
– Band of German Silver 35-38
gauge
– Band was annealed for
better adaptation and then
polished.
– Holes present at the ends
and tightened around teeth
twice with floss
– Ligature was then saturated
with sandarac or other
varnish to prevent slippage.

83. Fille Brown Matrix
(Fille Brown 1889)
– Consisted of a
performed, thin metal
band with
projections at the
edges
– These projections
held the ligation to
secure the band
– Wedges were placed
inter proximally

84. Black Matrix
(Black 1899)
– Was a circumferential ligated
matrix
– Consisted of a band which
was ligated.
– Band made of copper, brass
German silver or steel with
cervical corners turned up to
accommodate a ligation
– Perry separator used for
separation
– Matrix was wedged and
stabilized with compound
after binding the ligation to
the band.

85. • Andrews Matrix (Andrews 1886)
– Band of a thin strip of copper nearly encircling
the tooth and affixed with ligature of floss silk
wrapped around the matrix 4 –5 times.
• Baber Matrix (Baber 1886)
– Used silver plated copper for increased
illumination into cavity

86. Abernethy matrix (Abernetty
1937)
• Used small ligature
wire instead of floss
to secure the band
– Compound or shellac
held in a bridge tray
was applied to the
matrix and the tooth
– Tray had a hole cut in
top to provide access
into the cavity

87. Hollen Back Matrix (Hollen Back
1937)
– Modified the early tie band matrix
– Stainless steel band 0.002 inch (51m) thick
with a hole in each end.
– Ligature was passed through holes and
wound around teeth 2 –3 times
– Matrix was secured with low fusing compound
– Drawback was the lack of wedging

88. Markley modification (Markley
1951)
– Modified the tie band
matrix with a thinner
band of stainless steel
0.0015 inch (38m)
– pre-contoured with an
ovoid burnisher and
was wedged.

89. Hampson Modification
(Hampson 1961)
– Suggested a wedge to be used with
Hollenback matrix
– Ivory No. 1 retainer was used to stabilize the
compound.

90. CONTINUOUS LOOP MATRIX

91. – Was introduced for cavitites involving three or
more surfaces
– Some early types
• Herbst Matrix
• Weirich Matrix

92. Herbst matrix
– Used a circumferential band and
a wooden wedge
– Band was bound to the tooth
and soldered
– Wedged after placement

93. Newkirk modification
• Newkirk in 1908 modified the matrix by using
different materials for the band like
steel,thinned copper or german silver
• If closer adaptation at the cervical margin
were needed the cervical edge of the band
could be pinched with pliers

94. Soldered Matrix (Biales 1944)
– Modification of the Herbst continuous loop
matrix
– Bands were of carbon steel / stainless steel
which was contoured with pliers placed on a
tooth and drawn taut with flat nosed pliers
– Then band was removed and soldered along
the seam

95. • Spot Welded Matrix
– Bands were of stainless steel
(6.4mm x 38m to 8mm x
51m)
– Matrix is arched to the tooth
and welded along the seam
– Band is wedged to the tooth

96. Tinner’s joint matrix
– Instead of a
welded joint ,a
tinners joint was
used with a Mc
Kean Master
separator.

97. • Welded circumferential matrix (Tocchini
1967)
– Performed and manufactured by Unitek Corp
• Rivet Matrix (Tocchini 1959)
– A rivet was used to secure the free ends of the
continuous bands.

98. Collar or Band Matrices
– These consisted of a seamless, continuous
band made of gold, platinum, copper or
German silver
– The band was applied to the tooth and
wedged
• Harrison Matrix (Goodhugh 1921)
– Modification to the band or collar matrix
– Nickel or German silver collar adapted to the
tooth with pliers by pinching the collar at the
facial surface

99. Copper Band Matrix (Markley
1951)
– Modified the collar or
band matrix which
consisted of a seamless
copper band
– Band was wedged and
stabilized with compound
– To facilitate contour, the
band was further
annealed and trimmed.

100. Use of Copper Bands
• A seamless annealed copper band is used
• Select the smallest copper band that will fit over
the circumference of the tooth but still touch or
nearly touch the proximal surfaces of the
adjacent teeth
• Before trying a band on the tooth,festoon the
gingival end with a caved crown and bridge
scissors to correspond to the level of the gingiva
• Rough edges are smoothened with a sand
paper disc or mounted rubber wheel

101. • Then contour the cut ends with a no.114
contouring pliers
• Slightly withdraw the wedge placed during
the preparation of the tooth to allow
teasing of the band between the wedges
and the gingival margins
• Continue the try in of the band and adjust
the gingival end until the band extends
approximately 1mm past the gingival
margins

102. • When the band is in place on the tooth use a
sharp explorer to scribe a line around the outer
surface of the band to indicate the correct
occlusal height which should be 1-2mm above
the marginal ridges
• Remove the band and cut off along the scribed
line and smooth any rough edges
• Reduce the thickness of the band by relieving
the outer surface in the area of each proximal
contact area using a rotary sandpaper disc or a
suitable mounted stone

103. • For further adaptation crimp
the facial surfaces in the
gingival 1/3rd with a no.110
pliers.Evaluate proximal
contours and contacts
• Replace the band and insert
the wedges
• Compound is applied to
stabilize the band and
improve its adaptation to the
tooth in its gingival aspect of
the facial and lingual
surfaces

104. Removing of the Copper bands
• Carefully cut a groove occluso gingivally
on the facial and the lingual surfaces of
the band with a no.2 bur
• tear the band apart along these grooves
with an explorer and remove these two
sections in an oblique direction
occlusogingivally or occlusofacially.

105. Punch – Band Matrix (Miller 1959)
– Used Nickel – ferrule in the matrix of Harrison
instead of copper
– It was pinched and soldered along the seam

106. Weirch Matrix ( Weeks 1894)
– Consisted of a single
band of metal alloy
– One of the edges made
into a loop and the free
end was threaded
– After band placement the
free end was wrapped
around the loop again

107. T-Band Matrix /Ash matrix
(Brown 1955, Gainsford 1956)
– Also called Dr.Levetts matrix consisted of a
steel band 0.002inch (51m)
– Band was of German silver or copper was
thinned by grinding with a carborundum
stone at the contact area
– It is indicated with teeth with short crowns
– it is then wedged at the gingival margin.

109. Other continuous loop matrices
• Hazlett Matrix (Gustafsson and Magnusson
1977)
– Matrix got constriction by means of small locks
• Automatrix (LD Caulk Co,USA, 1973)
– Consists of a coiled band 0.0015 – 0.002inch (38 -
51m) thick
– Coiled band placed with college pliers and tightened
around tooth with the Automate 11 instrument
– After used auto lock is removed with shielded rippers

111. ADVANTAGES
• Ease of manipulation
• Convenience
• Improved access and
visibility
• Multiples
automatrices can be
placed in the same
quadrant
DISADVANTAGES
• Expensive
• Need for accessory
items
• Difficulty of contouring
the band

112. • Cleartrix Matrix (Parkell Product Inc.
USA)
– Was a retainer less matrix with self locking
adhesion ends for light cured resin material

113. ADVANTAGES OF DISADVANTAGES OF
CUSTOM MATRICES
ADVANTAGES
• Most of them
reproduce the desired
anatomical contact
and contour
• Suitable for two and 3
surface restorations
• Most of them are not
bulky so can be used
on more than one
tooth
DISADVANTAGES
• Time consuming for
fabrication and
manipulation

114. MATRICES WITH
MECHANICAL RETAINERS

115. • The matrices with mechanical retainer
were introduced as a consequence to the
difficulty of manipulation of the custom
matrices
• Consists of a screw clamp
• Can be used for 2 or 3 surface
restorations
• Bands of steel, phosphor-bronze or
German silver, carbon, celluloid and
plastic
• Thickness of bands 0.001 to 0.003inch
(25-76m)

116. Early matrices
– Creager (1885) introduced
the loop matrix and
retainer
– Had band with screw
affixed for tightening the
band

117. Guilford Matrix (Guilford
1886)
– Small holes punched
near the end of the bands
which extended around ¾
of the tooth
– Band tightened with a
clamp which had a screw
that was tightened wit a
watch key

118. • Brophy Matrix (Brophy 1886)
– Bands of various sizes,
– Band penetrated by a blunt
pointed screw which when
engaged with a watch key
secured the band to the
tooth.
• Wood word Band Matrices
(Wood word 1885)
– Band was of No. 30
phosphor-bronze material
– Band was drawn around
the teeth with a screw
threaded between two
posts.

119. Wood ward double screw
matrix
– Steel band in various sizes
– Two screws – one on each
end
– When tightened against the
adjacent tooth the screws
ensured separation of the
teeth and security of the
matrix

120. • Hinker, lodge and hewitt
matrices
– Consisted of a steel band and
jackscrew
• Crenshaw matrix (Newkirk
1908)
– Matrix was designed in various
size and shapes for back to back
or two surface restorations

121. • Ladmore – Brunton
Matriz (Fillebrown
1889)
– Incorporated a
jackscrew with a flexible
key.
– Consisted of a
band,mechanical
retainer and a wrench

122. Dickinson Matrix (Hardy 1908)
– A pair of rotatable, plow shaped
metal wedges which were attached
to the retainers and approximated
to one another by a screw instead
of a spring
– Band was available as a single or
double band and is still used today
– Double band is also known double
matrix

123. IVORY MATRICES
• Original ivory matrix
– Introduced in 1890
– Indicated for restoration of 2 –surface
cavities
– Band extended around 3/4th of crown
and was retained by projections of the
jaws of the retainers passing through
holes in the band and engaging in the
facial and lingual embrasures on the
side of tooth opposite the cavity.
– It was wedged and burnished for better
contour and contact after matrix placed.

124. Ivory No. 1 matrix and retainer
– Modified the original ivory
matrix
– Hands 0.0015 – 0.002 in (38 -
76m) made of brass, shim
steel ,carbon or steel in
various sizes and shapes.
– Band contoured with ovoid
burnisher or contouring pliers
– Wedge was placed
– previously compound was
also placed.

125. Ivory No.2 Matrix and Retainer
– Introduced in 1892
– A spring loaded retainer was
used
– Yoke engaged the spring to
lighten the jaw of retainer and
band to the tooth
– Was unpopular as this too
produced loss of contour and
contact

126. Ivory No.3
– Introduced in 1898
– The retainer held the band
firmly and allowed close
adaptation to the cervical
portion of the tooth without
damaging gingiva.

127. Ivory No.4
– Introduced in 1900
– Was quite similar to
Dickenson retainer
except for changes
in shapes and length
of the wedges to
increase separation.

128. Ivory No.5
– Introduced in 1900
– Indicated for the
placement of two
surface restorations

129. Ivory No.8
– Introduced in 1905
– Indicated for restorations
of three or more surfaces
and bands were of steel
or celluloid
– Bands were threaded and
fastened into the vice of
the retainer by the end
nut and tightened.
– Improvised version, the
vice had a wide double
surface

130. • Ivory No.9
– Introduced in 1905
– Indicated for three or more
surfaces
– Bands 0.0015 to 0.003 in (38 -
76m) of carbon / stainless
steel
• Ivory No.14 and 14 S
matrices and retainers
– Introduced in early 1900

131. • Harpex Matrix (Harper
1933)
– Modified the Ivory No.4
– Has adjustable springs at the
end of the jaws
– After the placement, the
retainer is tightened to the
tooth whereby the springs are
composed between the band
and the adjacent tooth
• Abernethy Matrix
(Abernethy 1937)
– Modification of ivory No.4
– Strips of band metal soldered
to retainer and disposed
parallel to the facial and
lingual surfaces to serve as
trays.

132. • Lawrence Matrix
– Variations of ivory No.4 to
accommodate an impression
tray
– Impression of unprepared
tooth is made by using jaws
as trays
– Upon placement the retainer
with compound impression is
tightened to the tooth and
band.
Mizzy Matrix (Mizzy 1935)
– Consisted of a band and a
retainer with two metal sliding
wedges

133. • Bonnalie, lennox,
Biber, Onderdonk
and Wagner
Matrices (1930’s)
– Circumferential band
which could be cut on
a curve and retained
with a thumb screw
retainer

134. Siqueland Matrix (1940’s)
– Also circumferential band
with thumb screw retainer.
– When placed the band is
tightened to secure the
cervical and free occlusal
portion
– For 3 or more surfaces
– Contained a swivel lock

135. • Mec Matrices (1940’s)
– Similar to the Ivory No.8
– Steel band 0.0018 – 0.002 in
(46 –51 m)
– Band was accurate, contoured
and wedged
• Mec – N retainer
– Introduced in 1947
– Modification of the original mec
matrix
– Has an oblique opening and an
angulation of 30o

136. Tofflemire Matrix / Universal Matrix
(teledyne Get, USA)
– Designed so that band could
be easily removed from the
thumbscrew retainer
– Became the most popular
matrix
– Band of stainless steel
0.0015-0.003 inch (38 - 76m)
and is accurate
– Precontoured with
contouring pliers and
burnished after matrix
placed.

137. Using the Tofflemire retainer
• Turn the vice moving nut until the slotted
vice is about an inch from the inner end
of the retainer band
• Hold the vice moving nut and turn the
vice screw nut a number of turns in the
opposite direction till the pint of the
spindle clears the diagonal slot channel
for reception of the free ends of the band
• Insert the occlusal edge of the band
selected upon the diagonal slit.The
preshaped loop is thus formed
• Tighten the vice screw to lock the band in
the vice

138. • Guide the looped end of the band gently
over the tooth
• The slotted end of the vice should face
gingivally to facilitate the easy occlusal
removal of the retainer
• The size of the loop may be increased or
decreased by turning the vice moving
knob.

139. All purpose matrix (All purpose
dental instrument Co. USA)
– Introduced by Reiter
1958
– Band was thin,
ductile stainless
steel
– When placed
lingually retainer can
be converted to a
contra angle retainer.

140. MATRIX BANDS

141. • The non contoured
band can be shaped
with a ball burnisher;
first a smaller one and
then a larger
burnisher or a clark’s
triplex contouring
pliers

142. Arcuate Bands
• The inability to reproduce well contoured
restoration with approximal contact due to
the acute angles formed between band and
cavosurface margins brought about the
concept of the curved or arcuate bands
which were placed around the prepared
tooth.
– Cervical edge of the band was shorter than the
occlusal edge
– It reproduced the contact and contour of the tooth
better.

143. • Twist band
– Made of stainless steel (5/16 x 0.002 in) and
was twisted at angle of 45o.
– The circumferential twist band was originally
suggested for use with the ivory 8 and 9 and
later with the Toffemire retainer.
• Zolnowski twist band
– The band was twisted at the appropriate
angle to flare occlusally

144. • Dixieland band
– This band was configured so that the contact
would be located midway between the occlusal
and cervical edges of the band
Ho band
Band available in dead soft and regular stainless steel
0.001 in (25m) thick

145. • Contact Molar band
– This is a precontoured arcuate band of clear
plastic
• Catalar Band
– This is an arcuate band of clear plastic
shaped similar to universal band used with
Tofflemire matrix

146. PRECONTOURED MATRIX
STRIPS
• Many precontoured
matrix strips like the
palodent and the
Darvag are now
available.

147. MATRICES AND
MECHANICAL
SEPARATORS

148. • This combination of matrix band and a
mechanical separator was in early use
like the Darby matrix & Screw separator
SPRING CLAMP MATRICES
Used for two surface
restorations
Consists of a strip of metal
held in position by spring
clamp

149. SPRING CLAMP MATRIX
APPLIED TO A TOOTH

150. Miller Matrix (Brophy 1886)
– Was indicated for back to back
restorations
– Matrix consisted of steel band in
the form of spring leaflets in
various sizes and shapes.
– But it was too rigid for adequate
adaptability

151. • CONTEMPORARY SPRINGS CLAMP
MATRICES
– Other spring clamp matrices are
• Walser Matrix
• Apis Matrix

152. • Walser Matrix
– Consisted of a band of
stainless steel 0.002
in(51m)
– Placed with an instrument
• Apis Matrix (Endres
1952)
– Indicated for compound
restorations

153. MATRICES FOR CLASS I
EXTENSION CAVITY
PREPARATION

154. • Generally matrices would not be necessary
for conservative Class I restorations except
in certain extensive cases with lingual or
facial extensions.
• Double – banded tofflemire usually used.

155. • Tofflemire matrix is placed
around the prepared tooth and
an additional step of cutting a
small piece of stainless steel
material 0.002 inch thick and
0.31 inch wide and placed
between the lingual/buccal
surface of the tooth and the
band.
• The gingival edge of the
segment of matrix material is
applied slightly gingival to the
gingival edge of the band.

156. • Select a wedge that will create and maintain the
proper separation between the two bands and
thereby enable the proper contour facially or
lingually.
• Insert the wedge between the band and the
band piece after coating the wedge with
compound.
Then immediately use a burnisher when the
compound is still soft to press the compound
gingivally to tightly secure the matrix.
• Sometimes if the wedge is properly stabilized by
itself ,the use of the compound can be avoided.

158. MATRICES FOR CL II CAVITY
PREPARATION

159. • Tofflemeire
• Ivory No.1
• Ivory No.2
• Blacks Matrices
• Soldered band or seamless copper band
matrix
• Roll in band (Automatrix)
• S-Shaped Matrix band
• T-Shaped Matrix band
• Sectional Matrix

160. UNIVERSAL MATRIX
• Indicated in three surfaces MOD or MO or DO
cavity preparations.
• ADVANTAGES
– Can be positioned on the buccal or on the lingual side
by using the contra angled type.
– The retainer also helps to hold the cotton roll in place.

161. • In MODs , when one of the proximal
margin is deeper gingivally a band may
be trimmed for permitting a matrix to
extend further gingivally for deeper
gingival margins.
• A mirror is used to inspect the proximal
aspects of the matrix band facially and
lingually to verify if the contours and
contacts has been achieved.

162. COMPOUND SUPPORTED
• Now a days rarely used but is an alternative
to universal matrix.
• It is rigid and provides a better contact and
contours and specially with short crowns.
• 0.002 inch band contoured to produce
concavity and then placed .
• The wedge is placed.
• And the band pressed against the buccal and
lingual walls by inserting piece of softened
compound.

163. AUTOMATRIX
• Indicated for extensive class II
preparations especially when two or more
cusps have to be replaced.
• Advantage
– Can be positioned either on the facial or
lingual surfaces with equal ease
• Disadvantage
– Bands are not precontoured so proximal
contouring is difficult.

164. COPPER BANDS
• For MOD and complex restorations a
continuous band is indicated.
• Can be kept till the restorations sets.
• usually used for amalgam fillings involving
more than two surfaces.

165. MATRICES FOR CLASS III
CAVITY PREPARATIONS

166. • Usually used are transparent
plastic strips.
– Silicates cements – celluloid
strips and mylar strips are
used.
– Resins – cellophane strips
and mylar strips can be
used.
• A suitable plastic strip is
burnished over the end of the
steel instrument to produce a
belly in the strip for attaining
proper contour.

167. • In distal surfaces of canine cavities , the
metal band is moulded into S shape and
stabilized with wedges or compound.
• If the preparation is small and the matrix is
sufficiently rigid the use of compound can
be avoided in certain cases.

168. Teeth with irregular
arrangement
• A suitable plastic strip is
contoured and adapted.
• A compound impression
showing the imprint of the
cavity is taken and then
warmed mildly.
• Strip is placed into position
followed by the impression
and material is introduced
from the labial side.

169. For two adjacent proximal
preparations
• A loop half inch in
diameter is formed in
the matrix strip.
• It is made into a T
shape by the finger
and trimmed.
• It is then placed
between the teeth.

170. MATRICES FOR CL IV
PREPARATIONS

171. • PLASTIC STRIPS
• Suitable plastic strip is folded and moulded into ‘L’
shape.
– One side of the strip is cut so that it is as wide as the length
of the tooth.
– The other side is cut so that it is as wide as the width of the
tooth.
• A modified ‘S’ shaped band can also be used
• It is wedged in place.

172. • Care should be taken for the angle formed by
the fold of the strip approximates the normal
corner of the tooth end and supports the
matrix on the lingual surface with fore finger
of the left hand.
• Cavity filled to slight excess and one end of
the strip is brought across the proximal
surface of the filled tooth.
• The other end is folded over the incisal edge.
• The matrix is held with the thumb of the left
hand.

173. • Aluminum foil incisal corner matrix.
• These are ‘stock’ metallic matrices
shaped according to the proximo-
incisal corner and surfaces of the
anterior teeth.
• Advantage
– Can be adapted to each
specific case
• Disadvantage
– Cannot be used for light cure resin
material
Prefabricated matrices

174. Transparent crown form matrices.
• These are ‘stock’ plastic
crowns.
• In bilateral class IV preparation
the entire crown can be used
and in unilateral cases crown
can be split inciso - gingivally
into two halves for the
respective side.
Anatomic matrix
• Preferable in multiple
involvements.

175. MATRICES FOR CL V

176. The commonly available matrices for class
V restorations are :
• Prefabricated plastic matrices – for light
cure restorations
• Aluminium or copper collars – for non
light coloured restorations
• Anatomic matrix – for light and non light
cured materials

177. Window matrix
mainly for amalgam restorations
• It is formed using
either a Toffelmire or
a copper band matrix.
• A window slightly
smaller than the
outline of the cavity is
cut on the band
• It is then placed and
wedged.

178. • ‘S’ shaped matrix is indicated for a
proximal extension of buccal or lingual
Class V amalgam restoration.
• For wide Class V amalgam restorations
prepared in two stages
– The mesial half is prepared first and filled with
amalgam and then after the initial set, the
distal half is prepared and restored.

179. Prefabricated plastic matrices
• Available in different
sizes.
• A handle is provided
to hold the matrix in
place till the material
sets .
• Used with light cure
restorations.

180. Aluminum or copper collars
• for non light colored
restorations.
• They preshaped according to
the gingival third of the buccal
and lingual surfaces.
• They are mounted on a tip of
a softened stick of compound
which is used as a handle.
• fill the cavity with restorative
material and apply to the
adjusted collar on the tooth.

181. Anatomic matrix
• After restoring the defects on the
model a plastic template is
prepared and cut mesiodistaly
keeping its occlusive/incisal
portion and the facial and the
lingual parts where the defects
are.
• Then trimmed gingivally and
used as the matrix for applying
pressure and keeping the
restorative material while curing.

182. Restorations for very wide proximal
extensions with a tofflemire matrix
• When there is a wide proximal extension of the
cavity the matrix band tends to encroach on to
the proximal seat while tightening it.
• To prevent this after proper wedging lightly
loosen the retainer resulting in slackening of the
band.
• This is then burnished to the neighboring tooth
more buccally to correct approximation.

184. • Placement of matrix in deep extended
gingival margin cavities
– Loosen the wedge a small distance for the
band to go between the loosened wedge
and the gingival margin
– Tilting (canting) of the matrix pushes it into
position
– Supporting the matrix with the blade of
Hollenbeck carver leaned against it during
full insertion of the wedge prevents it from
pushing the matrix

185. Restoration of severely fractured teeth using a
flexible facial matrix
(polyvinyl siloxane putty material)
– When endodontic therapy is
indicated for the restoration of
fractured teeth, use of a matrix
helps in the preparing the
tooth for proper facial and
incisal reduction.
– Using a flexible facial matrix
allows the dentist to ensure
that proper facial reduction is
accomplished.

186. Richardson 1991 operative dent jr

187. MODIFIED MATRIX TECHNIQUE FOR
APPLICATION OF RESTORATIVE
MATRIX ON FACIAL SURFACES OF
TEETH
Duokoudakis 1994
A Tofflemire matrix is modified and is secured
in place with the help of super floss and
unfilled light activated resin.
• The matrix prevents excess cementing
medium escaping in the gingival area
providing excellent isolation.

189. Tooth separation

190. • Tooth movement is an act of either separating
the involved teeth from each other and/or
changing the spatial position in one or more
dimensions
• SEPARATION-
– For the proper reproduction of physio
anatomical features of teeth with a restorative
material, tooth movement and matricing must
accompany or precede restoration procedures

191. – Improper configuration of the proximal area
may
• Cause displacement of teeth buccally,
lingually mesially or distally
• Cause vertical or horizontal food impaction
• Cause rotation the teeth
• Cause injury to the investing structure due
to excession opening or closing the contact
and interproximal embrasures
• Disturb the axial relationship of the teeth
• Disturb the coordination of the inclined
planes and cusps causing defection
occlusal contacts

192. Objectives of tooth movement
• To bring drifted,tilted or rotated teeth to their
indicated physiological positions as
prerequisite for proper reproduction of the
proximal surfaces
• To move teeth from a non-functional or
traumatically functional position to a
physiologically functional one
• To move teeth to a position which is most
esthetically pleasing
• To create a space sufficient for the thickness
of the matrix band interproximally.

193. • Two methods are generally employed for
accomplishing separation
– Slow separation
– Rapid or immediate separation

194. SLOW SEPARATION
• Teeth are slowly and gradually forced apart
by inserting certain materials between them
• Advantages
– Repositioning occurs physiologically without
injuring periodontal ligament fibres
• Disadvantages
– Time consuming and requires many visits
• Materials used
– base plate
– Gutta percha
– Orthodontic wire or Fixed orthodontic appliances
– Wood or Rubber

195. RAPID OR IMMEDIATE
SEPERATION
• More valuable method
• Should be carefully applied and handled
• Advantages
– Quick and useful in clinical conditions
• Disadvantages
– May rupture the periodontal ligament fibres
– Induces pain at the site

196. RAPID SEPERATION
• WEDGE PRINCIPLE
• TRACTION PRINCIPLE

197. WEDGE PRINCIPLE
• Accomplished by the insertion of a pointed
wedge shaped device between teeth in
order to create space at the contact area.
• The more the wedges move facially or
lingually, the greater will be the separation
• Two types are
–Mechanical devices like Elliot
separator and Perry separator
– Wedges

198. Elliot Separator
• Indicated for short
duration separation
that does not
necessitate
stabilization
• Useful in examining
proximal surfaces
• Final polishing of
restored contacts

199. Wedges leading to separation
• Triangular wedges were used
• On cross section
• The base of the triangle in contact with the
interdental papillae, gingival to the gingival
margin of the proximal cavity
• The two sides coincide with the
corresponding two sides of the gingival
embrasure
• The apex of the triangle coincide with the
gingival start of the contact area

200. • Different types of materials used for
wedges
– Wooden wedges
– Metal wedges
– Silver wedges
– Celluloid or plastic wedges
– Medicated wood wedges

201. Procedure
– Prior to placing the first wedge, a ‘shield
wedge’ was placed to protect the gingiva
– Then the second wedge was forced between
the contact points of the teeth achieving
maximum separation required.
– The first wedge was further seated and the
2nd wedge was removed

202. WEDGES

203. • A wedge is usually a piece of wood, metal
etc, one of which is an acute angled edge
formed by two covering planes used to
tighten or exert force in various ways
• A wedge is used nowadays commonly in
conjunction with matrices for inserting
plastic restoration materials.

204. Functions of wedges
• Assure close adaptability of the matrix
band to the tooth
• Prevents gingival extrusion of restorative
material
• Define gingival extent of the contact area
• Create separation to compensate for the
thickness of the band
• Atraumatic retraction of the rubber dam
and gingiva.

205. Selection of wedge
• Is based on four variables
– Convergence angle of the base
– Mesio - distal width of the base
– Gingivo - occlusal height
– Concavity of the side walls

206. HISTORICAL PERSPECTIVE
• The wooden wedge had been in use for
separating teeth before the advent of the
matrix
• The materials used then were box wood,
orange wood, balsam wood and soft pine

207. Ottolengire steel wedge (1891)
• U shaped, consisting
of two arms
• Arms squeezed
together for
placement which
spring back to hold
the wedge in the
embrasure

208. Messings wedge
Wedge made of silver
– Sterilizable and could be bent
– Contour side to provide contour to the
restoration and flat side to give
frictional resistance against adjacent
tooth
– The end was grooved to fit the beaks of
dressing forceps for easy insertion and
withdrawal

209. PRESENT DAY WEDGES
• Today wedges commonly used are
available in
– Wood
– Celluloid or plastic
• Wedges may be purchased precontoured
or shaped by the dentist to better
accommodate their placement and
adaptation to the band

210. • Wedges are also
available as ‘left’ &
‘right’ for application
to mesial and distal
spaces (Products
Dentaris)

211. INSTRUMENTS USED
• Earlier instruments were used to assist in
placing and contouring the wedge
• Examples –
– Chase dental wood forceps
– Miller wedge cutting pliers
• Jack in 1871 suggested gum sandarae or
mastic to support and retain the wedge
• Much later modeling compound was
recommended

212. WEDGE PLACEMENT
• The decision as to whether the wedge should be
inserted buccally or lingually is a made after
inspecting the cavity preparation with the
appropriate band in place.
• In lower ,it is preferred buccally as a lingual wedge
interfere with the tongue.
• In maxillary teeth it is preferred from the buccal side
• Test for the tightness of the wedge
– by pressing the tip of an explorer firmly at several points
along the middle 2/3rd of gingival margin along the matrix
band
– Also try to remove wedge with an explorer applying
moderate pressure. It should not dislodge the wedge

213. PIGGY BACK WEDGING
• Done when the wedge is significantly
apical of the gingival margin
• A smaller wedge is piggy backed on the
first
• This method is useful in patients with
recession of the interproximal tissue level

214. • DOUBLE WEDGING
– Two wedges one from
the lingual and other
from the facial
embrasure used in
restoration for wide
proximal restorations.
– It should be used only
if the middle 2/3rd of
the proximal margins
can be adequately
wedged.

215. • Wedge wedging
– Done when a
concavity may be
present on the
proximal surface
– A second pointed
wedge can be inserted
between the first
wedge and the band.

216. • Anatomic wedging
– Used for deep gingival margins
– Base toward gingiva and the apex towards
the contact area.

217. INCORRECT WEDGING
CORRECT WEDGING

218. When extremely large interproximal space
is present a suitably trimmed tongue blade
can wedge a matrix
If still larger then wedging is not feasible
and special care is exercised while placing
small amounts of amalgam in the gingival
floor and condensing in increments of 1
mm without the wedge

219. RECENT ADVANCES

220. RECENT ADVANCES
• The clinical techniques for using conventional
matrix products rely on compensating for the
thickness of the matrix by forcefully separating
the teeth.
• Since the amount of separation cannot be well
controlled or even quantified, the amount of
spring back and therefore the tightness of the
resulting contact is unpredictable and
inconsistent.
• Having matrix bands with contact areas with the
same thickness as the normal inter-proximal gap
eliminates the need for separation

221. MICROMACHINED MATRIX
PRODUCTS
The micromachining of the matrix
material by selective thinning
and contouring of their contact
area have set the stage for a
number of clinical techniques.
• The contact areas can now be
thinned to only 0.0003 inch and
surrounded by a frame work of
0.0015 inch thick stainless steel.
• It is also contoured to provide a
concavity on the surface facing
the preparations.

222. • The recent micromachined matrix products
currently available include
– Tofflemire type bands
– Sectional strips that are used with ivory no 1
retainer
– Tie system employing two pieces of dental
floss.

223. MICRO BANDS
• These are designated to fit in conventional
tofflemire retainer
• Can be used with amalgam / composite resin .
• The micro band tightened around any tooth will
still produce a tight seal and thereby prevent
over hangs just by its fit.
• Apart from its tightly adapted gingival edge the
middle of the bands proximal surface is free from
restrictions so it can be pushed out proximally as
far as necessary to create a full and definite
contact.

224. • The bands contain a hole that fits easily
around the intact contact on the
uninvolved side even when there is a tight
contact.
• Available thickness
– 8 microns (0.0003 inch)
– 12 microns(0.0005 inch)

225. • Available shapes
– 2 S MUDL
– 2 S DUML
– 3 S
• MUDL: used for mesial
surfaces of upper teeth or distal
surfaces of lower teeth on the
left side and vice-versa on the
right side.
• DUML:used for distal surfaces
on upper teeth or mesial
surfaces of lower teeth on the
left side and vice-versa on the
right side.

226. Advantages of microbands
• Eliminates the need for separation
• Shiny metal acts as a mirror to reflect
incident curing light into the deep portions
of restorations.
• Can be seated even when there is very
tight contact on the uninvolved proximal
side.

227. MICRO STRIPS
• The matrix strips made of stainless steel
• Thinned to 0.0003 inch at the contact area and
0.0015 inch for the rest of the band.
• They can be pre bent by rolling between the
thumb and forefinger until they achieve as much
as curve as desired.
• Types
– MS 1
– MS 2
– MS 3
– MS 4

228. MS 1
• MS 1 is used for CL III and CL IV fillings on
anterior teeth and for simultaneous banding of
multiple veneers.
• Can easily pass through natural contacts
• Slits on the top can form handles that facilitates
placement
• The hole on top allows easy removal with an
explorer after procedure

229. • Can be bend and held
around tooth using
fingers floss or strip of
rubber dam material.
• Produce better
contact and contours
than mylar strips.

230. MS 2 AND MS 3
• MS 2(premolar) and MS 3(molar)
are used for class II restorations.
• Ivory no 1 is effective for securing
the gingival edges of MS 2 or MS
3 strips very tightly.
• Dental floss can also be used.

231. MS 4
• This is used for bonding a single
veneer or for bilateral class III
restorations.
• For single veneer
– Can be rolled between fingers to give a
concave curve so as to fit around te
lingual surface of the tooth to be
restored and curves in opposite
directions so that its peripheral portions
stay close to the label surface of the
adjacent teeth.
• Class III restorations
– Can be tied with floss at gingival
borders and pulled tightly around the
gingival margins of the restorations.

232. CLEAR MATRIX
• This can be used with tofflemire retainer and light
reflecting wedges.
Advantages
• Allow penetration of curing light from multiple
directions -can be cured from the proximal and
gingival directions other than the occlusive
aspect.
• Allows more favorable direction of polymerization
shrinkage.

233. ULTRA THIN METAL MATRIX
• Can be used with tofflemire retainer.
• Advantages
– Easy to place
– Shape is maintained better
– Can be burnished against the adjacent tooth
• Disadvantages
– In case of class II restorations metal matrix wraps
around the facial and lingual surfaces of the tooth and
the increments must be initially cured only from the
occlusal aspect and after removal the proximal resin
composite may be further polymerized from the facial
and the lingual aspects.

234. PRE-CONTOURED MATRIX
BANDS
• These are preshaped anatomical matrix
bands
• Used with tofflemire retainer
• Gives good contour to the restoration

235. Strip T Matrix system
• Designed to assure
accurate proximal tooth
form replication in direct
application restorations in
posterior and anterior
teeth.
• Can be easily contoured
for each specific
applications.
• The predrilled hole is used
to insert dental floss for
easy removal and safety.
• Band is 0.0015 inch
stainless steel.

236. • Advantages
– Wide variety of clinical applications
– Easy to use.

237. Sectional matrix & contact ring
• Introduced by Mayer
• Principle based on equal and opposite forces
exerted on the contacting teeth by tines of the ring.
• Matrices come in various sizes, thicknesses and
shapes depending on the matrix.
• The system relies on a sectional matrix with inner
concavity to give form to the proximal restoration
wall.

238. • Advantages
– Provide wedging to ensure good inter – proximal contact.
– Provide better proximal contact for posterior resin
composite restorations.
– Simplify matrix placement for single proximal surface
restoration, compared to circumferential band.
• It should be recognized that the ring provides
progressive tooth separation, so if left in place for a long
time ,excess separation can occur resulting in a very
tight contact.

239. Super Mat
• System constitutes a super lock
instrument and the super cap
spool which holds a selected
matrix band.
• Band can be metal, plastic and
bimatric system.
• Anatomically shaped polyester
posterior matrix bands for light
curing materials can be used
with this system.
• Gives an anatomical form to the
restored tooth surfaces.
• Available as molar and pre molar
bands.

240. Squeeze matrix
• Anatomically shaped bands with integrated
fixing device.
• Used for
– Light curing resins
– Resin inlays in posterior teeth.
• Available as molar and premolar bands.
• Advantages
– Easy fitting without special instrument.
– Excellent closure.

241. Bimatrix
• Light cured resins require transparent matrices.
• Due to consistency of the type of plastic, it is often
difficult to pass through tight contact points.
• Bimatrix has both metal and transparent plastic parts.
• Advantages
– Transparent section helps in direct curing of resins.
– Steel section is rigid enough to pass through tight contact
points.

242. Stop strips
• Polyester strips with re-enforced
stay or self adhesive tape at the
end.
• Passed through a suitable
interdental area and fixed by
means of a stay.
• Placed around the separation
• The opposite end is held away
from the cavity.
• Advantages
– No hinderence to light curing.
– No need to hold the matrix band
with a finger.

243. Light reflecting wedges
• Anatomically pre – shaped light conducting plastic
interdental wedges.
• It has an inner white structure which reflects the light
sideways and a curved tip.
• Available in 3 sizes:
– Ultra narrow
– Small
– medium
• Used in conjunction with clean matrices in class II
restorations.
• If clean matrix is being used the initial curing should be
directed through the flat end of the wedge.
• Light reflecting wedges will direct the curing light to the
gingival margins of the restoration and draw the
polymerization shrinkage towards that margin.

244. Flexi wedges
• Flexi wedges have graduated
side depth for superior fit.
• Traditional flat – bottomed
wedges deliver force to both the
teeth and gingival,but with flexi
wedge less pressure is placed on
the gingival.
• Unlike smooth plastic
wedges,these wedges have
mantle finish and directional
retentive arms to secure the
position after they are placed.

245. • Because it confirms to a multitude of root forms and
irregularities, saliva and blood are prevented from
seeping into the preparation.
• Available in 5 different sizes,which are color coded
as
– Red
– Purple
– Green
– Orange
– Blue

246. Contact Pro 2 & Light tips
• These devices can aid in achieving tight
contacts
• Especially used when wide restorations
are made and a less that ideally contoured
circumferential matrix is used by
necessity.
• These systems are difficult to use for
routinely normal sized restorations.

247. Contact
Pro 2
• Helps to achieve tight contact
• Delivers light into the deepest part of the proximal
box to facilitate composite curing
• Available as
– small
– big
• The instrument has 2 ends,which facilitates its use in
mesial and distal surfaces.
• The technique is designed to ensure
– adequate inter – proximal contact
– Minimize the thickness of resin composite that the light
must penetrate.

248. Light curing tips
• Simplest device to obtain tight proximal contact
in cervical areas for class II restoration.
• Available in different sizes
• Can be autoclaved.

249. Trimax contact forming instrument
• The introduction of composite, matrix retainer, wedges
and contact – forming instruments has resulted in
techniques to expedite and provide more predictable
composite placement.
• The trimax contact forming instrument with disposable
light conducting inserts is used to achieve tight contacts
in class II composite restoration.
• The instrument is contra angled on one side and straight
in the other end and has depression for better grasping.
• Each side of this instrument permits four different
positions by 90 rotation.
• Each side of the instrument as a recess through which
light can be passed.

251. • Advantages
– Achieving tight anatomical contact areas
– Conducts light into the composite possibly
reducing microleakage and improving the
degree of conversion and physical properties.

252. Pre – polymerized composite
balls
• The use of it has been suggested to aid in establishing
tight inter – proximal contact.
• The normal incremental technique is used until the
proximal box is filled to just before the proximal contact.
• A small, slightly flattened ball of composite is prepared
on the tip of an instrument.
• An additional increment of uncured resin is placed into
the box.
• It is pushed into the increment to wedge the matrix tightly
against the adjacent tooth ,then the resin composite is
cured.
• In case of MOD cavities prepolymerized composite rods
can be used to achieve contact.

253. • Occlusal Contacts
• Occlusion refers to contact relationships of
the maxillary and mandibular teeth.
• When the jaws are in closed position with
maxillary and mandibular teeth in maximal
interdigitated contact, the occlusal
relationship is termed as centric occlusion.

254. • Centric Occlusion
• An ideal centric occlusion occurs at a
proper vertical dimension coincident with
centric relation position of mandibular teeth.
• Centric relation is the relationship of the
mandible to the maxilla when the
mandibular Condyles are in the most
superior position in their respective glenoid
fossa with the articular disc properly
interposed.
•

255. • A stable centric occlusion results in
• i) Proper distribution of the contacts involving all
opposed posterior and anterior teeth.
• Ii) A pattern of contact that produces stability of
both tooth position and relationship of mandible
to the maxilla by directing the vertical centric
closure along the long axis of the teeth while
maintaining centric position of the mandible.

256. • Forces of stable vertical centric closure directed along
the long axis of the
•
Centric contacts in the posterior segments of the arch
occur ideally at the cusp tip of one tooth contacts the
central fossa or marginal ridge area of its opponent.
• Faciolingually there are two ranges of centric contact,
facial and lingual.
• The facial range of posterior centric contacts involves the
mandibular facial cusp tips contacting the central fossa
regions and mesial marginal ridge areas of opposing
maxillary teeth.

257. • The lingual range of posterior centric contact occurs with
the maxillary lingual cuspal tips contacting the central
fossa regions and the distal marginal ridges of the
opposing mandibular teeth .
• Posteriorly centric contacts should result in an axially
oriented force by virtue of a convex cusp tip occluding on
the opposing tooth surface that is perpendicular to the
force.
• However centric contacts often occur on the inclines of
posterior teeth. These incline contacts must be balanced
by an equal contact on an opposing incline to resolve the
forces in the axial direction .
• Contacts that occur on the inclines are referred to as
poded centric contact. Stable centric contact may occur
on two or three or four opposed inclines and are reffered
to as bipoded, tripoded or quadrapoded contacts.

258. • Tripoded contact— Central pit of maxillary first
molar
• Quadrapod contact- Central pit of mandibular
second molar.
•
The anterior teeth have only one range of centric
contact which are in line with and are in
continuation with the facial range of posterior
contact.
• The incisors may not contact in either centric or
lateral functional relationships.
• The canines are unique in that they have
anatomical and functional characteristics that are
transitional between anterior and posterior teeth.

259. • Maxillary and mandibular centric occlusion
pattern.
• In ideal occlusion supporting cusps and
centric stops are involved.

260. • Centric occlusion , the occlusal contacts can be
divided into the following types:
• i) Surface contact ii) cusp and fossa contact iii) ridge and
embrasure iv) ridge and groove contact.
• Eccentric occlusion:
• It include i) lateral and protrusive contacts, ii) Non
functional disclusion
• i) Lateral and protrusive functional occlusion
• Functional occurs in segment of the arch toward to which
the mandible move with the . Lateral functional occlusion
involves the canines and the posterior teeth toward which
the mandible moves.
• Canine guided lateral functional occlusion.
• The opposing maxillary and mandibular canines provide
contact during lateral functional excursive movement and
there is a complete disclusion of all posterior teeth in the
functional segment.

261. • Grouped Lateral Functional Occlusion.
• This provides dominant guidance by the canines but
involves sharing of contact by the posterior teeth in the
functional segment.
• There are 2 potential ranges of lateral functional contacts
on the multicuspid posterior teeth, a facial range and a
lingual range.
• The facial range involves the mandibular facial cusps
moving from their area of centric contact facially and
distally across the lingual inclines of the maxillary facial
cusps.
• The lower cusp tips will pass through the embrasure
spaces and grooves and actual functional contact will
occur on the distal arms or ridges of these cusps.

262. • Non Functional Disclusion.
• They are undesirable in natural dentition.
They are of 2 types.
• Lateral non functional contacts. These
contacts occur on the opposed inclines
between the zones of the centric contact. The
zone of potential nonfunctional contacts
occurs on the lingual inclines of the
mandibular facial cusps and the facial
inclines of the maxillary lingual cusps.

263. • Protrusive Non Functional Contacts.
• These may occur on either or both the
right and left posterior segments.
• The facial range occurs when the
mesial cusp ridge of the mandibular
facial cusps contact the distal slope of
the triangular ridge of the maxillary
facial cusps.

264. • In an ideal arrangement of teeth the facial to
lingual zones of potential contacts of
maxillary posterior teeth.
• Zone 1: Lingual inclines of facial cusps-
lateral functional contact.
• Zone 2 : Central groove area -centric contact.
• Zone 3: Facial inclines of lingual cusps-
lateral nonfunctional contact.
• Zone 4: Lingual cusp tips-centric contact.
• Zone 5: Lingual inclines of lingual cusps-
lateral functional contacts.

265. • The facial cusp tips and facial inclines of he facial of
the maxillary posterior teeth normally have no contact
potential.
• In ideal arrangement of teeth, the facial to lingual
zones of potential contact of mandibular posterior
teeth.
• Zone 1: Facial incline of facial cusps -lateral
functional contact.
• Zone 2: Facial cusp tips- centric contact.
• Zone 3: Lingual inclines of facial cusps-lateral
nonfunctional contact.
• Zone 4: Central groove area -centric contact.
• Zone 5: Facial inclines of lingual cusps -lateral
functional contact.
• The lingual cusp tips and inclines of lingual cusps of
the mandibular posterior teeth normally have no
contact point.

266. • Hellman in 1941 observed 138 points of
occlusal contacts.
• 1) Lingual surface of upper incisors and
canines.-6
• 2) Labial surfaces of lower incisors and
canines- 6.
• 3) Triangular ridges of upper buccal
cusps of pre-molars and molars- 16
• 4) Triangular ridges of lingual cusps of
lower premolars and molars-16
• 5) Buccal embrasures of lower premolars
and molars-8
• 6) Lingual embrasures of upper
premolars and molars-10

267. • 7) Lingual cusp points of upper
premolars and molars-16
• 8) Buccal cusp points of lower premolars
and molars-16
• 9) Distal fossae of the molars-12
• 10) Mesial fossae of upper molars-6
• 11) Distal fossae of upper molars-6
• 12) Lingual grooves of the upper molars-
6
• 13) Buccal grooves of the lower molars-6

268. CONCLUSION
 There are several methods of achieving a right
contact in direct restorative procedures, using
various systems/techniques available.
 It is important that the clinician is aware of all
the systems and posses the knowledge to use
them.
 The selection of the system has to be done on
case to case basis keeping in mind the type of
restorative material being used.
• It is also essential to establish proper contacts
and contours so that the restoration can serve to
its fullest purpose.

269. References
• Operative dentistry -Sturdevant 4th edition
• Operative dental surgery-Messing and Ray
• Operative dentistry - Marzouk
• Operative dentistry - charbineau
• Operative dentistry – supplement 1986,91,94
• Textbook on Operative Dentistry-Vimal K.Sikri
• Dental Anatomy - Wheelers.