Restoring Class II cavity preparations with direct posterior composite resin presents a challenge to many dentists. An improper contact can allow food to become trapped, leading to recurrent decay or periodontal breakdown. Recently, products such as preformed inserts, curing light tips and packable composites have been developed to help create a better contact. Also, an inventive technique has been advocated in which orthodontic separators are placed.1 This simple technique does not require special instruments or materials and can be performed at the diagnostic visit.
TECHNIQUE
After the preparation has been completed, place the matrix band and wedge in the usual manner. Etchant, primer and unfilled resin are applied according to the manufacturer’s directions. After an initial increment of flowable composite has been placed and cured on the floor of the proximal box, express a portion of hybrid composite onto the blade of a plastic instrument and approximate it to the ideal size of the contact (by placing it on the burnished area of the matrix band and forming it). This portion can then be removed easily. When the size and shape are satisfactory, cure this portion while it is still on the instrument blade. At this point, the matrix band can be loosened slightly. The remainder of the box is then filled with composite, the customized contact portion is reap-proximated, and lateral force is applied to hold the contact portion tightly against the adjacent tooth while it is being cured.
This technique can be a cost-effective way to deliver a high-quality restoration.
Next, inspect the area for voids that can be filled, and finish and polish the restoration. If the band and wedge have been placed properly before the initial increment is added, there should be minimal flash to remove.
CONCLUSION
This technique is easy to learn and does not require the purchase of special products or a separate office visit. As more dental professionals use direct Class II composite as their material of choice, this technique can be a cost-effective way to deliver a high-quality restoration.
DO YOU HAVE A TIP TO SHARE?
Do you have a time- or work-saving clinical technique to share with your colleagues? Submit it to JADA’s Clinical Directions department. A Clinical Directions item should be a maximum of two double-spaced typed pages and should include no more than one figure or illustration. Submit items to Clinical Directions, JADA, 211 E. Chicago Ave., Chicago, Ill. 60611.
