CATEGORY AUSTRALASIAN DENTIST71 relief from the treatment delivered. Here is the exact step-by-step process to close contacts and get rid of food traps quickly and easily: Step 1 Place Rubber Dam with clamp and secure against leakage (see Figure 5). **For those who like to fustigate and nd aws, please note that I am very well aware of the open gap along the canine, which was well monitored throughout the entire procedure and no leakage occurred. Step 2 Prepare teeth for restoration. Step 3 Place matrix of appropriate size (Figure 6), and slide wedge of appropriate size to secure the band in place (Figure 7). You may need to use your nger to hold the band in place while placing the wedge. Step 4 Place selected Garrison ring with forceps and ensure full seat (see Figure 8). See below for a short discussion of Garrison rings. e ring is placed with the loop of the ring towards or away from the forceps (depending on how the clinician chooses to restore), gripping it in the notch of the forceps and squeezing the forceps to open the ring slightly in order to place where needed down over the wedge. Once seated, the ring squeezes the teeth gently, causing slight separation so that the restorative material can then be placed in the correct contour and 3-dimensional place in order to ensure a tight, positive contact with the adjacent tooth. Step 5 Follow your adhesive protocols and, if using a owable restorative material, place it where needed and light-cure (Figure 9). Composite resin is then added in the proximal area rst and light-cured. Once the proximal contact is created, additional composite is then added in order to nish the restoration. If restoring a number of teeth at the same time, multiple rings can be used for e ciency and speed. See below for more information. Step 6 Once cured, the ring, band, and wedge can be removed. Note that very little ash or excess resin remains with proper band and ring placement and the restoration can be polished quickly. e proximal contact is then checked and con rmed resulting in elimination of the food trap, and its related consequences. System Used: Strata-GTM Sectional Matrix System from Garrison Dental e system used here to achieve solid, wellcontoured, positive proximal contacts is the Strata-GTM Sectional Matrix System from Garrison Dental (see Figure 11). is kit has de nitely been designed for the busy clinician and for the anxious patient who bene ts from many of the features that allow speed, e ciency, and exceptional quality and contour in the nal restorations. e kit comes with a variety of bands, wedges, rings, polishers and the Garrison ring placement forceps. ere are a number of unique features to note in this kit, which is why I choose it for my composite restorations routinely. e bands (matrices) come in not only a variety of sizes including a new pedodontic size, but also in a soft and rm version. ese bands have a built-in enhanced marginal ridge to help the clinician shape it e ortlessly. Band selection is simply based on the one that most closely resembles the occluso-gingival height of the tooth you are working on (see Figure 6). e contour of the band naturally follows the tooth shape and conforms to it, resulting in little or no ash when nished (see Figure 12). e wedges are shaped to sit deeper due to their design and exibility, sliding easily to seal the area completely (see Figure 13). e wedge should be placed from the widest embrasure, between the band and the adjacent tooth, creating the seal and contour needed for a smooth nish. e rings are Nickel Titanium (Nitinol) treated with plastic reinforcement, increasing their strength and resiliency. ey last much longer than other rings because they bounce back to their original shape. e shape of the ring is what helps the clinician reduce ash, saving time when nishing and polishing. ese rings come in various sizes and can be used to restore multiple teeth at the same time by stacking the taller ring over the shorter ring in di erent areas concurrently. e wide ring is convenient when there is a portion of the cusp missing, allowing the clinician to contour easily without having to go through multiple steps. at’s it. at’s all there is to it. Super easy and very rewarding. And the best part is that you can get the same results instantly by following this step-by-step process. I’d love to hear from you and nd out if you have used any of these strategies. Leave a comment. u CLINICAL Figure 5 Figure 11 Figure 13 Figure 7 Figure 9 Figure 6 Figure 12 Figure 14 Figure 8 Figure 10 About the author Dr. Agatha Bis, DDS practices in Oakville, Ontario, Canada. Dr. Bis received her Doctor of Dental Surgery degree from University of Western Ontario in 1996, and her Bachelor of Science from University of Toronto in 1992. With years of clinical experience and thousands of hours in post-graduate training, her unique focus and expertise in treating Temporo-Mandibular Joint Disorder and comprehensive restorative dentistry, along with the use of digital technology, has led to developing exceptional systems to diagnosis and treatment planning, helping chronic pain patients treat their unresolved jaw pain, migraines and headaches.
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