In previous posts I have talked about the challenges we encounter with composites that extend interproximally. Pre-wedging the teeth and proper selection and placement of a matrix system are two critical steps for creating consistently tight contacts. Preparing the tooth with convenience form is a key component that allows us to see and trim and adjust the margins of the interproximal portion of the restoration. With all of these key pieces in place I was still struggling with shaping the occlusal portion of the marginal ridge to create the proper shape to the occlusal embrasure, and sometimes polishing the interproximal box margins.
Recently it dawned on me that I am wedging before I begin preparing the tooth to create an interproximal space, why not wedge after the tooth is filled to create the same space and facilitate the trimming and polishing phase. For the last few weeks I have been removing the separator ring, band and wedge after the prep is filled and the composite cured. Then repositioning the wedge before I begin trimming and polishing. this small step allows me vastly improved access for my mosquito diamond, the tip of a white stone and discs to perfect the shape of the interproximal contact, occlusal and gingival embrasure form and marginal interface. Similar to when we shape the interproximal of a provisional you do not want to polish or adjust the area that composes the contact, which was created by proper band placement and contour, but right up to it.
Cool idea Lee! We usually use a sectional matrix and then trim the embrasures with sand paper disks. They contour really nice that way and many times will also help us roll in the marginal ridge too. Then a RAPTOR bur gives really nice anatomy that we finish off with a mini football diamond.
Love that tip! This is definitely an area I continue to struggle as well!! I’m trying that immediately!!