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Initial tooth preparation: Occlusal outline form (occlusal step): The occlusal outline form of a class II tooth
Entering the pit nearest to the involved proximal surface allow the mesial pit (in this case) not to be included if it is sound. Proper depth of the initial entry cut is 1.5 to 2mm (i.e., one half to two thirds the length of the cutting portion of a No. 245 bur), 1.5mm as measured at the central fissure, and approximately 2mm on the prepared external walls
The objectives for extension of proximal margins are to: Include all caries, faults, or existing restorative material. Create 90-degree cavosurface margins (i.e., butt joint margins). Establish (ideally) not more than 0.5mm clearance
With the same orientation of the bur, position it over the DEJ in
the pulpal floor next to the remaining mesial marginal ridge.
Allow the end of the bur to cut a ditch gingivally along the
exposed DEJ, two thirds at the expense of dentin and one third at the expense of enamel. The 0.8mm diameter bur end will cut approximately 0.5 to 0.6mm into dentin and 0.2 to 0.3mm into enamel.
Extend the ditch gingivally just beyond the caries or the proximal contact, whichever is greater. Because dentin is softer and cuts more easily than enamel, the bur should be
The location of final proximal margins. (i.e facial, lingual, gingival) should be established with hand instruments (i.e.,
overextended to achieve 90-degree cavosurface margins with the No. 245 bur.
The proximal ditch cut may be diverged gingivally to ensure that the faciolingual dimension at the gingival is greater than at the occlusal. The gingival divergence contributes to retention form and provides for desirable extension of the facial and lingual proximal margins to include defective tooth structure or old restorative material at the gingival level, while conserving the marginal ridge and providing for 90 degree amalgam at the margins on this ridge.
If additional use of the bur is indicated, a matrix band may be used around the adjacent tooth to prevent marring
Primary resistance form is provided The pulpal and gingival walls being relatively flat and perpendicular to forces directed with the long axis of the tooth; Restricting extension of the walls to allow strong cusps and ridges areas to remain with sufficient dentin support Restricting the occlusal outline form (where possible) to areas receiving minimal occlusal contact.
Secondary resistance form in final tooth preparation involves both resistance of the remaining tooth structure against fracture from oblique forces and resistance of restorative material against fracture.
The occlusal convergence of the facial and lingual walls and the dovetail design (if needed) provide sufficient retention
To enhance retention form of the proximal portion, proximal locks may be indicated to counter proximal displacement.
Reverse Curve
Matrix system
A matrix system provides and takes the place of the proximal tooth surface that was removed to restore the proximal contours and contact to their normal shape and function.
Matrix bands Matrix bands are made of flexible stainless steel and are available in premolar, molar, and universal sizes and thicknesses. The larger circumference of the band is the occlusal edge and is always placed toward the occlusal surface.
The
smaller circumference of the band is the gingival edge and it is always placed toward
the gingiva.
Universal retainer Also referred to as the Tofflemire retainer. This device holds the matrix band in position. The retainer is positioned most commonly from the buccal surface of the tooth being restored.
Matrix retainer
Sectional Matrices
A
thin polished palodent-type band and a tension ring produce a tight anatomic contact for composite resin materials for class II restorations.
Sectional matrices.
Automatrix
Copper Band
Wedges
A
wedge is either triangular or round and made of wood or plastic. wedge is inserted into the lingual embrasure to position the matrix band firmly against the gingival margin of the preparation.
The