'Get it Right, Get it Tight' - Matrix Systems (downloadable)

‘Get it Right, Get it Tight’:

‘Get it Right, Get it Tight’ P. Sai Naveen Kumar

Introduction :

Introduction Human teeth are designed in such a way that the individual tooth contributes significantly to their own support, as well as collectively support the stomatognathic system. Failure to respect and preserve these relationships will not only cause premature failure of the restoration but also periodontal problems as well as initiation of caries around the adjacent tooth structures . 7/31/2011 'Get it Right, Get it Tight' 2

Problems associated with faulty reproduction of contacts and contours:

Problems associated with faulty reproduction of contacts and contours Food impaction / retention Gingival recession Gingival inflammation Fractured restoration Faulty occlusion -> distal migration of untreated tooth Gingival irritation Periodontal complication -> acute abscess or bone loss. Shifting of teeth (mesial drift). 7/31/2011 'Get it Right, Get it Tight' 3

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7/31/2011 'Get it Right, Get it Tight' 4 Contact areas contours Marginal ridges occlusion

Procedures for formulation of proper contacts and contours:

7/31/2011 'Get it Right, Get it Tight' 5 Procedures for formulation of proper contacts and contours Intraoral procedures - Tooth movements - Matricing Extra oral procedures - Wax pattern - Cast adjustments

What is Matricing?:

What is Matricing ? It is derived from the Latin word “Mater” i.e. mother. The first successful matrix was introduced in to dentistry by Dr. Louis Jack in 1871. A dental matrix may be defined piece of properly shaped material which forms the missing wall of the restoration which gives form and shape to the restoration during insertion and condensation of restorative material. 7/31/2011 'Get it Right, Get it Tight' 6

Components of a Matrix System:

Components of a Matrix System Band - which is a piece of a metal or polymeric material used to support and give form to the restorative materials during its introduction and hardening. Matrix retainer - is a device by which band can be retained in its designated position and shape. The retainer could be a mechanical device, a wire, dental floss or a compound Wedges - Wedges are used interdentally to ensure close adaptation of the matrix band with the gingival seat of prepared proximal cavity. 7/31/2011 'Get it Right, Get it Tight' 7

Functions & objectives:

Functions & objectives 7/31/2011 'Get it Right, Get it Tight' 8

Specifications:

Specifications To achieve optimum results, the matrix must meet the following requirement Ease of application. Removability. Rigidity . Height. Proximal contours Position of the matrix- It should always be 1 mm below the gingival seat and 1 mm above the marginal ridge. Thickness of matrix band - 0.002 or 0.0015 inch thickness 7/31/2011 'Get it Right, Get it Tight' 9

Classification:

Classification Based on anatomic contour Anatomic matrix Non anatomic matrix Based on material used Metal Copper Brass Celluloid Based on the support Compound supported Non compound supported Based on the dentition Deciduous Permanent 7/31/2011 'Get it Right, Get it Tight' 10 Based on the retainer Automatrix Matrix with retainer Based on shape or design Straight Contra angled. Based on the position Circumferential Unilateral

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7/31/2011 'Get it Right, Get it Tight' 11 Gilmore’s classification: Custom made Mechanical - Miscellaneous Class 2 amalgam matrices may be generally be classified as : Isaac Kaplan et al 1986 Custom made Preformed mechanical

Evolution of matrix systems:

Evolution of matrix systems 7/31/2011 'Get it Right, Get it Tight' 12

Black’s matrices:

Black’s matrices The blacks matrix is one of the early custom made matrices. Introduced in 19 th century. It consist of thin strip of stainless steel metal placed on the proximal surface and then tied around the tooth with dental floss or ligature. 7/31/2011 'Get it Right, Get it Tight' 13 With gingival extension Black’s matrix

Soldered band or seamless copper band:

Soldered band or seamless copper band 7/31/2011 'Get it Right, Get it Tight' 14 Indicated for badly broken down teeth especially those receiving pin retained amalgam restorations with large buccal and lingual extensions.

Ivory number 1 and 8:

Ivory number 1 and 8 7/31/2011 'Get it Right, Get it Tight' 15 Ivory matrix 1 Ivory matrix 8

Tofflemire matrix:

Tofflemire matrix 7/31/2011 'Get it Right, Get it Tight' 16 Slots Retaining screw Adjusting nut Locking nut head vise

Anatomic matrix:

Anatomic matrix Most efficient means of reproducing contact and contour. Entirely hand made and contoured specifically for each individual case. Especially useful in mutilated teeth. 7/31/2011 'Get it Right, Get it Tight' 17

Automatrix :

Automatrix 7/31/2011 'Get it Right, Get it Tight' 18 Band is self retained by holding one end of the band and rolling the other end over itself, decreasing the band length and consequently, the matrix diameter until it fits tightly over the tooth and preparation. Ratchet is used to clinch the band securely to the tooth. 3. Wedging not usually required. 4. Removed in angular direction

Sectional matrices and contact ring systems:

Sectional matrices and contact ring systems The McKean principle of separation is based on equal and opposite forces exerted on the contacting teeth by the tines of the ring. The force vectors can be resolved into mesial and distal components, these components providing separating forces. The separation is time dependent phenomenon with the separation increasing with time. When the contact ring is removed after composite placement and curing, the tooth returns to its equilibrium position. The space taken up by the sectional matrix is eliminated. 7/31/2011 'Get it Right, Get it Tight' 19

Three systems based on the McKean concept are available: :

Three systems based on the McKean concept are available: Palodent BiTine and BiTine ii Contact Matrix (Danville Materials) Composi -Tight (Garrison dental solutions) The McKean , Danville, Garrison have retentive designs. The first two have converging tines, and the Garrison has retentive balls at the tine end. The Palodent with parallel tines ,lacks retentive design. 7/31/2011 'Get it Right, Get it Tight' 20

NEWER MATRIX SYSTEMS:

NEWER MATRIX SYSTEMS 7/31/2011 'Get it Right, Get it Tight' 21 A. Transparent posterior matrix band with integrated fixing device B. Anatomic matrix C. V-Ring - the world's first Nickel-Titanium sectional matrix retainer ring

Conclusion :

Conclusion Any operative procedure should be aimed at restoring proper tooth form , function and aesthetics while maintaining the physiologic integrity of teeth in harmonious relationship with adjacent hard and soft tissues all of which should enhance the general health and welfare of the patients . 7/31/2011 'Get it Right, Get it Tight' 22

References :

References Text Book of pediatric dentistry. Third edition Pinkham. Art and Science of operative dentistry second edition. Chifford M. Sturdvent. Studevents Art & Science of operative Dentistry fourth edition. Theodose M. Roberson, Heraldo Hymen, Edward J. Swift. Wheelers Dental Anatomy, Physiology and Occlusion. Sixth edition Major M. Ash. Operative dentistry. Modern theory and Practice. Second edition M.A. Marzouk, A.L. Simonton, R.D. Gross. Dental Anatomy : Its relevance to dentistry – fourth edition Julian B. Woelfel. A Tofflemire Time Saving Tip . By JS Blalock. Operative Dentistry 2003, 28, 345. Effect of different application and polymerization techniques on microleakage of proximal resin composite restoration. In vitro PA Brunton A Kassir M. Doshi JC Setcos. 7/31/2011 'Get it Right, Get it Tight' 23

Acknowledgements :

Acknowledgements Dr. Nagesh MDS (Prof & HOD dept of conservative & endodontics) Dr.Ch.R. Sunil MDS (Professor) Dr.Ch. Sujana MDS (Reader) Dr. Archana MDS (Sr. Lecturer) 7/31/2011 'Get it Right, Get it Tight' 24

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7/31/2011 'Get it Right, Get it Tight' 25 Thank you