Using contoured tofflemire amalgam bands for posterior composites?


In my office I have a number of matrix systems for achieving good posterior class II composite contacts. Yes I have and sometimes use the V3 system by Palodent, but most often I use the V3 ring with an .35 Stainless steel contoured Tofflemire amalgam band that I have cut into the appropriate shape using my crown and bridge shears. In effect, cut it so that it becomes a sectional matrix and I only use the most contoured part to fit interproximally. This band is quite stiff and holds its shape and resists unintentional deformation when burnished with a rounded dental instrument.

After I place it with a wedge and the V3 band I carefully push it more fully towards the adjacent tooth. This burnishing motion will cause the band to slip slightly to help ensure that the band is better adapted to the adjacent contact area. If the gingival contact has a gap I may "double wedge the band from both the buccal and lingual. If needed, I can shave the shape of the wooden wedges that I employ, either using a blacks knife or a scalpel, to help with their proper placement and to better allow the a long and wider contact area in my composite. This can take extra time, but it can help create a better shaped contact area for the filling.

There only two possible negatives  to my  technique.  First, it can be difficult to use this matrix if my class two preparation doesn't result in a broken contact. The band can still be used but I must pre-wedge the contact area with a good amount of force. The second and more significant issue is that this band is both stiff and sharp and often can make a small "paper cut" like cuts in the gingival papillas, especially when removing it after the filling is placed. Care should be taken  to minimize this unintentional trauma . That being the case, these cuts, when they occur, heal rapidly and aren't really a "deal breaker' for this technique.

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/02/using-contoured-tofflemire-amalgam.html - http://lspindelnycdds.blogspot.com/

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