Australasian Dentist Magazine May June 2021

Category 52 Australasian Dentist C omposite resins are, and for the foreseeable future, the most widely used direct restorative material for restorations involving anterior teeth. Today’s composite materials offer practitioners tremendous physical properties but also optical properties to deliver lifelike restorations on a consistent basis. Proper finishing and polishing, together with the right occlusal scheme can provide the opportunity for these restorations to last a long period of time. Though the handling characteristics of modern composites are vastly improved dentists still struggle with the development of good inter-proximal contacts and proper anatomical contours. Utilizing an anterior matrix system can be paramount in achieving this objective. Matrix systems in the anterior region are numerous in respect to creativity but the majority can be classified into flexible and rigid. Flexible matrices include the popular mylar strip and soft splint templates that can be challenging as they lack the ability to contour large areas leading to irregular contours and contacts. Rigid matrices include putty indexes and pre-contoured posterior sectional matrix, both viable options in certain situations but the majority of time posterior matrices are cumbersome and difficult to use when restoring multiple surfaces. To overcome a majority of these afore- mentioned limitations Garrison Dental has introduced the Fusion Anterior Matrix System. A simple matrix designed to be used for anterior restorations such as class III, IV as well as composite veneers. The firm stainless steel matrix easily slides into the sulcus all while maintaining the proper shape and contour without defor- mation. Properly placed the ideal anatomi- cal curvature is achieved in a gingival – in- cisal and facial – lingual direction. To help maintain this ideal anatomical position the Fusion Anterior Wedge is used to ensure a firm seal at the cervical margin from facial to lingual. These radically curved wedges help free up your hands to allow one to concentrate on composite placement and simplify the restorative process. This article is a case report of a direct composite restoration on a maxillary anterior tooth where the proximal contact and incised edge position were developed using the Fusion Anterior Matrix System. Case Report: A 74 year old male presented with an old class III composite on the distal portion of his left lateral incisor (Figure 1). Re-current decay was noted both visually as well as radiographically. Treatment options were discussed with patient and it was decided we would replace the restoration with a new direct composite restoration. Small amounts of composite were placed on to the tooth and light cured to get an idea of what shade or shades would be utilized. The patient was anesthetized with 1/2 carpule of 4% Articaine (Septodont) with 1:100,000 epinephrine. Isolation was obtained with a ComfortView® Lip & Cheek Retractor (Premier Dental). A pear shaped diamond bur (Meisinger) was used to remove the old restoration. A #2 round bur in a slow speed handpiece was used to remove all remaining decay and finally an 856 diamond bur (Meisinger) was used to bevel the facial margin and create a butt margin on the lingual. A short anterior Fusion Band (Garrison Dental) was then placed inter proximal past the finish line of the preparation and gently into the sulcus. A medium sized anterior Fusion Wedge (Garrison Dental) with its radical curvature was placed to ensure a firm seal at the cervical margin all while not Case Report: Anterior Matrix Systems Essential to Provide Proper Anatomical Form and Function to Your Restorations By Troy Schmedding DDS, AAACD clinical Troy Schmedding DDS Figure 1: Failing Class III composite on the distal – facial of the Maxillary lateral incisor Figure 3: Fusion Matrix being held from the facial while placing composite from the lingual. Figure 2: Fusion Anterior Matrix in place with Fusion Wedge to stabilize matrix and allow easy access for placement of phosphoric acid. Figure 4: Instrumentation of the composite performed to push the composite against the facial side of the Fusion Matrix