22 Sep Protecting the adjacent tooth – PolydentiaPRO interproximal protection matrix – DR. Chiodera
Protecting the adjacent tooth during cavity preparation and creating a custom wedge
by Dr. Giuseppe Chiodera
Dr Giuseppe Chiodera
Dr Chiodera graduated in Dentistry from the University of Brescia. In 2004, he won a scholarship to Kings College University in London. Honorary member of StyleItaliano, Dr Chiodera has been operating a private practice in Italy since 2006, specialising in conservative dentistry and endodontics. Dr Chiodera is also very active as an author of peer reviewed articles for national and international dental journals, as well as a lecturer at many universities.
clinical case
Protecting the adjacent tooth from nicks and scratches that occur during cavity preparation, when the bur inadvertently comes into contact with the neighbouring tooth, is essential to avoid damaging healthy tooth enamel.
The following documentation shows how these risks can be prevented using the new interproximal protection matrix PolydentiaPRO (Polydentia). It also displays how we created a valuable customised wedge that will be very useful during the restoration to achieve a correct result with a tight, anatomical contact point.
1: Pre-operative view showing the operating field with PolydentiaPRO inserted interproximally between carious molar #26 and premolar #25. The insertion of the matrix proved easy as the matrix, pre-shaped and contours, features extremities (as can be seen from the image) that serve as a guide to pull and slide the matrix through the interproximal space.
2:Unlike sectional matrices, we position PolydentiaPRO with the convex side facing the carious tooth. This placement provides it stability and the ability to withstand the force produced by the rotational movement of the bur. In addition, we have inserted a wedge to hold the matrix in place, thus achieving extra stability.
3:Opening the cavity with a dental bur. The use of a wooden wedge is not only advantageous for the stability of the matrix but also offers the clinician the possibility of obtaining a customised wedge, which is helpful for the creation of an anatomical and durable restoration (Back to Basics: Mind the Wedge – Chiodera 2017 [1]).
4: The image shows (source: Back to Basics: Mind the Wedge by Dr Chiodera 2017 [1]) the result of customising a wedge at the cavity opening. In this way, the customised wedge allows the matrix to anatomically close the space, allowing us to create a closed contact point and an anatomical, gap-free proximal margin.
5: Occlusal view of the clinical area after preparation of molar #26 and removal of the wedge. Note how PolydentiaPRO forms a shield that protects the adjacent premolar. (As mentioned before, we kept the wedge for use during the adhesive procedure.)
6: This image shows the damage that would have occurred on the adjacent tooth had we not used PolydentiaPRO. By doing so, we were able to keep the proximal structure of the adjacent tooth intact, and save time for finishing and polishing.
7: Restauro finale senza diga di gomma. Notare il punto di contatto stretto tra i premolari.
Senza QuickmatFLEX, non sarebbe stato possibile ottenere il restauro specifico. Grazie alle sue caratteristiche tecniche, la matrice sezionale QuickmatFLEX è facile da maneggiare e si adatta allo stretto spazio interprossimale sotto il filo ortodontico.
8: Post-operative view of the restoration.
9: The direct restoration after the one-year recall. Notice the tight contact point and the ultimate perimeter of our restoration on molar #36.
10: Final restoration without rubber dam. Check the tight contact point between premolars.
conclusion
PolydentiaPRO is a simple yet effective matrix to protect adjacent teeth from bur damage that can occur during cavity preparation. Its use is simple, and its contoured nature facilitates placement and removal. Furthermore, it enables us to achieve better and more anatomical restorations by allowing for wedge customisation to the cavity opening. PolydentiaPRO offers excellent help in preserving the neighbouring tooth proximal surface intact and provides clear economic advantages as it saves the time to polish iatrogenic damage or even the need to perform a new restoration.
references
1- ack to Basics: Mind the Wedge – Article by DR Chiodera. Year 2017. Published on: https://www.styleitaliano.org/back-to-basics-mind-the-wedge/
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Dr Chiodera - Protecting the adjacent tooth during cavity preparation and creating a custom wedge
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