What a matrix system has to do today: Good contacts!

Part of the “Class II Solution” filling concept: the Palodent V3 sectional matrix system.

Today, direct restorations with the help of composites are part of daily life in the dental practice. In this context, Class II fillings play a significant role, accounting as they do for a good 50 percent of all composite fillings. One particular challenge is designing the contact point. For this to be anatomically correct, predictable and simple to realize, a well-conceived and easy-to-use matrix system is required. The following article shows how the Palodent V3 sectional matrix system (Dentsply Sirona Restorative) meets these requirements, and how its use is of advantage when placing fillings.

For the long-term success of a direct restoration with composites, recreating the natural tooth morphology is of crucial importance, as this ultimately guarantees the restoration’s physiological functioning [1]. In this context, the design of the proximal contacts plays a particularly important role. If they are not modeled closely enough, this leaves excessively large interdental spaces where, for example, food residues can settle and, in turn, lead to the formation of pathogenic germs. An incorrectly designed proximal contact thus increases the risk of caries or local development of periodontitis [2], [3]. In view of this, restoring the natural tooth anatomy is an important factor for a successful prognosis [4]. Modern matrix systems such as the Palodent V3 sectional matrix system from Dentsply Sirona Restorative can help achieve this goal more easily and reliably.

A tightly integrated system

An essential component of the “Class II Solution” filling concept to treat Class II cavities, the Palodent V3 sectional matrix system provides anatomically correct outcomes for direct restorations. As well as matrices of various sizes, each with an easy-placement ‘tab’, the system also features wedges to adapt the matrices, interproximal tooth shields to protect the adjacent tooth during preparation, and separating rings made of nickel and titanium, specialized tweezers and application forceps.

The Palodent V3 ring proves particularly useful in practice. With its V-shaped apical tines made of glass-fiber-reinforced plastic, it makes the wedges easier to place. In earlier systems, by contrast, it was often difficult to position the ring, resulting in unfavorable instability. Its placement on the tooth to be treated did not provide an ideal result either, as the wedge partially absorbed the applied forces.

The Palodent V3 ring, however, is easy to place and leaves plenty of space for the wedges. These can be placed before or after the ring is positioned, as required. The hollow base allows a second wedge to be inserted and protects the papilla. The wedges ensure there is a tight seal in the apical area, prevent excess composite from accumulating and thus reduce the amount of finishing required.

In addition, the ends of the V-shaped tines on the Palodent V3 ring precisely match the shape of the matrix on the tooth being restored4. In this way, the forces exerted to separate the teeth can be better distributed.

Another practical advantage of the Palodent V3 system is the fact that all the matrices and the wedges have eyelets. This means that they are especially simple to position, and later to remove, using the special tweezers included in the system, featuring a pin that matches the eyelets. Lateral extraction by means of the eyelet proves particularly practical if both teeth press against the matrix after the retaining/separating ring is removed.

The matrices themselves are available in different sizes and their design enables the restoration to be designed precisely and anatomically correctly. One of the advantages is the contoured margin, which allows the marginal ridge to be restored. In addition to the concave matrices, the Palodent V3 system also includes two matrices with a convex profile in the apical area. This gingival apron is particularly useful when it comes to restoring deep defects extending into the cemento-enamel junction.

With the help of the Palodent V3 ring made of nickel and titanium, as well as the corresponding matrices and wedges, closely anatomically correct proximal contacts can be achieved.

Conclusion

Producing anatomically correct contact points is one of the most difficult tasks involved in a Class II filling. To reliably achieve this and thus ensure that the restoration is long-lasting, the Palodent V3 sectional matrix system provides all the tools needed to simply design proximal walls and marginal ridges. In combination with the other components of the “Class II Solution” filling concept, the system thus helps make the restoration of Class II cavities a success.

[1] Loomans BA, Opdam NJ, Roeters FJ, Bronkhorst EM, Burgersdijk RC, Dörfer CE. A randomized clinical trial on proximal contacts of posterior composites. Journal of Dentistry 2006;34:292–7.

[2] Abrahams H, Kopczyk RA. Gingival sequela from retained piece of dental floss. Journal of the American Dental Association 1983;106:57–8.

[3] Hancock EB, Mayo CV, Schwab RR, Wirthlin MR. Influence of interdental contacts on periodontal status. Journal of Periodontology 1980;51:445–9.

[4] Dao J. Teilmatrizensystem erleichtert Zahnrestaurationen. ZMK, Zahnheilkunde, Management, Kultur 1-2/2017; 52-59.