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Continuing Education
Case Report
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Compendium

June 2014, Volume 35, Issue 6
Published by AEGIS Communications

Triodent V4 Matrix System Eases Bulk-Fill Resin Placement, Improves Polymerization

Like many general practitioners, Gregory Gillespie, DDS, performs Class II restorations virtually every day. While he considers composite resin fillers “here to stay,” he says that “ever since the switch from amalgam to resin composite, dentists have wanted a composite resin material that handles more like amalgam, mainly because of the technique sensitivity of the layering procedure with composites.”

Therefore, Gillespie says, GPs welcomed the introduction of bulk-fill composites. Calling them “useful materials,” he says they have made it possible to place larger increments of composite prior to curing, rather than having to tediously layer and cure the material in small increments. The new bulk-fill materials, he adds, have especially simplified the placement of composite restorations in the posterior, where a single application of bulk-fill is usually esthetically sufficient.

“I feel, posteriorly, you can have one system, but you need to take a different approach in the anterior. There, layering is still important because of the need for high-end esthetics,” he says.

These attributes aside, the Vancouver, Washington, dentist notes that the traditional matrices used to establish tight contacts with amalgam were not as well suited to the more esthetic material now demanded by patients. The sometimes-sticky resin material would adhere to the bands and, with the use of larger increments of material, make it more difficult to achieve a complete cure.

New matrix systems designed for composite resins, Gillespie explains, are often Teflon coated to prevent the material from sticking, and their proximal contours are better than they were in the past. “High-end matrix systems really improve your posterior resin composites,” he asserts. This, he says, has been his experience with Triodent’s V4 ClearMetal Matrix System™ distributed by Ultradent Products, Inc. “When using a ring system like this, you can feel confident knowing that when you’re using composite, you’re going to get a tight fit. The rings fit nicely, they spread it apart, and they push the precontoured matrices so they fit right with the tooth. It’s so much easier to get beautiful contacts.”

Dentists who hesitate to switch to a bulk-fill resin are often concerned about whether it can polymerize completely, Gillespie says, adding that they worry about uncured resin in the deeper parts of the proximal boxes. The design of the V4 system, he notes, allows for a greater depth of cure. “It has a metal band, but the ring, wedge, and matrix are transparent to facilitate curing. Further, [the band] has numerous small holes that allow light penetration not just on top, but down deeper interproximally before removing the band, enabling the practitioner to cure buccally, lingually, or from any direction, and the matrix system doesn’t impede light penetration.”

Most of the higher-end LED curing lights made today are sufficient for completely curing bulk-fill restorations, Gillespie says—with these caveats: “You need a powerful light, which should be regularly checked for consistent output, and you need it to be collimated—that is, directed, not scattered.”

Gillespie further recommends that dentists concerned about depth of cure err on the side of allowing more curing time. “You can always undercure materials, but it’s very difficult to overcure them, so I like to go with 20 seconds from the occlusal, 20 seconds from the buccal, and 20 seconds from the lingual.” One of the biggest advantages with the V4 system, he points out, is being able to leave the matrix system on while curing. “I can cure from the buccal and lingual in a deep box and have confidence that everything is cured all the way to the bottom.”

Gillespie attests that the V4 matrix system enables him to easily and predictably complete the bulk-fill composite resin restorations that represent such a large part of the day of general practitioners like him. He adds that although he finds the V4 system extremely easy to use, he takes comfort in knowing that Ultradent’s direct sales force is fully available to answer questions and otherwise provide support to customers.

Ultradent Products, Inc.
505 West 10200 South
South Jordan, UT 84095
800-552-5512
dentalaegis.com/go/cced664