February 2009, Volume 5, Issue 2
Published by AEGIS Communications
The Composi-Tight 3D™ Sectional Matrix System
Traditional Tofflemire style circumferential matrices, while adequate for use with amalgam, often result in a less than desirable restoration when used with modern composites for Class II restorations. Sectional matrix systems are specifically designed to overcome the challenges of producing a tight, anatomical contact in these situations.
The sectional matrix ring is designed to create more tooth separation than the traditional Tofflemire/wedge combination through the application of spring tension in the interproximal space. This additional separation, in turn, is then used to compensate for the thickness of the matrix band and the polymerization shrinkage that occurs with composite material.
The Composi-Tight 3D™ Sectional Matrix System from Garrison Dental Solutions combines two styles of separator rings to allow secure ring application in a wide variety of case presentations. The orange Soft Face™ 3D-Ring (Figure 1) will be the ring used in most circumstances because, in addition to providing strong separating pressure, the use of contoured soft silicone faces allows for matrix band adaptation to a wide variety of tooth anatomies. The resulting reduction in flash makes final finishing and polishing faster. The Soft Face 3D-Ring also incorporates a slot in the underside of each tine so that it fits easily over the wedge.
The gray thin-tine G-Ring® (Figure 1), is used in certain conditions where the shape of the dentition will not allow the contoured shape of the Soft Face 3D-Ring to grip tightly around the tooth, such as the distal of a canine. In this condition, the burnished ends of the G-Ring will adapt and retain more effectively. The G-Ring may also be preferred for malpositioned or pedodontic applications.
Garrison matrix bands are contoured in three dimensions to provide an accurate contact at a tooth’s natural height of contour. They are made of ultra-thin, .0013” (33-µm) dead-soft stainless steel and come in a variety of sizes to match tooth height.
The technique for Class II restorations using the Soft Face 3D-Ring is as follows:
1. Place a rubber dam. Isolation of the area helps prevent contamination from blood and saliva. As with many dental procedures, aspiration of small parts is a valid concern.
2. Prepare the tooth with a conservative Class II preparation.
3. Place the contoured sectional matrix band (Figure 2). Select a matrix band that most closely approximates the occlusogingival height of the tooth. Over-approximate tooth curvature buccolingually by rolling the contoured band with your fingers. This will help keep the matrix band ends from interfering with the Soft Face 3D-Ring placement. The band should be oriented with the concave edge toward the occlusal margin of the tooth.
4. Insert a wedge (Figure 3). For optimal contour, gingival seal, and tooth separation, use Garrison’s Wedge Wands® or G-Wedge®. Keep a finger on the matrix band to prevent the wedge from dislodging the band during insertion. Wedge firmly. A high-viscosity resin packed into the preparation may displace the band away from the tooth.
5. Apply the Soft Face 3D-Ring retainer (Figure 4). Spread the Soft Face 3D-Ring with the Composi-Tight Ring Placement Forceps and place over the wedge. For secure gripping of the ring tines to the tooth surface, dry teeth thoroughly before placement.
6. Burnish the band. This step is very important. Burnish the band in the desired contact area against the adjacent tooth and make sure there is no spring-back of the band. This will ensure an excellent contact.
7. Use your preferred etching, disinfecting, and bonding technique following the manufacturer’s instructions. Apply your preferred composite resin following the manufacturer’s instructions.
8. Remove the 3D-Ring, wedge, and matrix band. Because of the superior contact achieved with Composi-Tight 3D, removal of the band may require a Composi-Tight Matrix Forceps or hemostats. This is especially true with particular bonding agents that preferentially bond to metal.
9. Contour and polish the restoration.
For stacking of rings and mesial-occlusal-distal restorations:
Both the Composi-Tight 3D Soft Face Ring (orange) and the thin-tine G-Ring (gray) are angled at 102.5° to allow stacking of rings for performing mesial-occlusal-distal restorations and multiple-tooth restorations. Either ring may be stacked over the other and in any combination.
These restorations are performed by selecting and placing both matrix bands, both wedges, and then the rings. Place the mesial ring first then place the distal ring on top. Burnish both matrix bands and complete the restoration as outlined above.
Use the correct forceps for applying the rings. Because of the strength of the 3D system rings, regular rubber dam clamp forceps do not open the rings adequately to allow placement on molars. Ring Placement Forceps from Garrison provide excellent control of the rings and the correct opening distance.
Tighten the wedge after ring placement. The considerable tension of the rings will separate the teeth, sometimes leaving the wedge slightly loose. It is important to drive the wedge further in to ensure that the gingival margin is properly sealed. This is easily accomplished with the Soft Face 3D-Ring’s over-the-wedge design.
Leave the handle on the wedge.If you are using Garrison’s Wedge Wands, you may prefer to leave the handle on the wedge after initial placement. This will facilitate easier tightening of the wedge after ring placement (as indicated in the previous tip) and simplify wedge removal when the procedure is complete.
Pre-separate on conservative preparations. If contact with the adjacent tooth is not broken, matrix band placement can be more difficult. This can be overcome with the use of Garrison’s FenderWedge® Interproximal Tooth Shield before preparation. Alternatively, a thin-tine G-Ring or a firmly placed wedge before preparation will begin tooth separation. When the preparation is complete, remove the FenderWedge, ring, or regular wedge and place the matrix band. An angled Matrix Band Forceps from Garrison Dental Solutions also aids in matrix band placement.
The Composi-Tight 3D Sectional Matrix System is made in the United States and is available direct in the United States or through major dealers in Canada. Additional product information including detailed information on Wedge Wands and FenderWedge as well as instructional videos are also available on line.
For more information:
Garrison Dental Solutions
The preceding material was provided by the manufacturer. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dentistry. The preceding is not a warranty, endorsement, or approval for the aforementioned products or services or their effectiveness, quality, or safety on the part of Inside Dentistry or AEGIS Communications. The publisher disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the preceding material.