PPD July Top Tip - Cervical Matrix

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top tips

Hero 360° cervical matrix

Leeds-based principal dentist Jon Swarbrigg presents his new and simple way to treat cavity cases with the help of Optident’s rotatable matrix

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riodent (UK distributor Optident), the maker of the ‘Top sectional matrix system’ awarded by The Dental Advisor in 2009, 2010 and 2011 has launched a new innovative product to help in the placement of adhesive restorations - the Hero 360° cervical matrix for the restoration of Class V cavities with materials such as composite or RMGI. Their rotatable matrices turn on two axes allowing easy access to all areas of a Class V restoration and even upper second molars (Figure 1). Due to the very smooth inner surface of the matrices, a great finish can be achieved and in less time.

Figure 2: Cavity is prepared

Figure 1: A rotatable 360° matrix allows easy access all over the tooth

TREATMENT This article presents a simple Class V cavity case on the lower premolar situated near the gingival margin. In previous cases, I would have attempted to place a retraction cord to expose the margin to allow precise marginal adaption and finishing. However, the Hero 360° cervical matrix has allowed me to

Jon Swarbrigg BChD MFGDP qualified from Leeds Dental Institute in 1992. Following graduation he joined Farsley Dental Practice, a mixed NHS/private general practice in Leeds, as an associate and became principal in 1999. Dr Swarbrigg enjoys complex restorative work including implants and undertakes referral work for simple and complex cases. He currently lectures to dentists in the use of anterior and posterior composite restorations and provides hands-on training. www.farsleydental.co.uk

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re-evaluate my technique in these situations. Its design enables me to encompass the cavity, therefore improving the adaption of the restorative material and also reducing the amount of finishing required, as minimal or no overhangs have been created. The cavity is prepared using Kavo ultrasonic restorative tips to avoid soft tissue trauma and allows for precise finishing. It also helps in the prevention of over preparation in this delicate area of the tooth (Figure 2). The 360° matrix comes in three sizes (small, medium and large) which are colour coded (Figure 3). Selection of the matrix is simple and is based on the size that fits and adapts

Figure 3: Hero 360° matrix comes in three colour-coded sizes

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Figure 5: Composite is cured through transparent 360° matrix

Figure 4: Three tweezer positions enable easier access Figure 6: Hero 360° matrix is easily removed with minimal finishing the best to the cavity margins that have been prepared and the contour of the tooth. The cavity is then cleansed and sealed with the bonding system of choice. In this case, a fourth-generation bonding system, Optibond FL, has been used in conjunction with Ultra Etch 35% phosphoric acid etch (Optident). Once the hybrid layer has been cured and formed, composite can be placed. Here, Kerr’s SonicFill (shade A3) was used to slightly overfill the cavity. The unique SonicFill delivery system means that the composite is delivered into the cavity in a precise and semi-flowable form

with no voids and, therefore, the material can be gently adapted to the cavity using a microbrush before placing the 360° matrix over the material. The flexibility of the matrix enables it to be placed subgingivally and with pressure, then gently shape and form the restoration to the contours of the tooth prior to curing. To enable easier placement, there are three tweezer positions to hold the matrix (Figure

4) and, because they are transparent, the composite is simply cured through the matrix when held in place (Figure 5). The matrix is easily removed and as seen in Figure 6, a small flash of material left around the cavity margins enables minimal finishing.

PROBLEM-FREE FINISH A size 12 scalpel blade simply removes the excess material and, if necessary, a fluted tungsten carbide bur, such as a Q Finisher (West One Dental), will gently smooth away any slight excess that is too thick for the scalpel to remove. As the matrix has formed an oxygen inhibited layer, the composite has a glass-like mirrored finish and therefore requires no more finishing (Figure 7). The 360° Cervical Matrix from Triodent will save practitioners time and enable them to produce predictable Class V restorations even in hard-to-reach areas due to its flexibility and ability to rotate. Its features definitely help overcome some of the problems faced when placing Class V adhesive restorations.

For further information or to place an order, please contact Optident on 01943 605 050 or visit www.optident.co.uk

Figure 7: Final restoration

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