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Friday, May 22, 2009

Which materials (matrix and interproximator) would be suitable for an in-the-mouth repair?

Hi, Dr Clark,

I have been, for some time, what I consider to be a practitioner and advocate of MID but your article raised my consciousness about aspects of our contemporary approach. The use of microscopes over loupes is inarguably an advantage. But the paradigm shift of class 2 preparation design is most thought provoking. I plan to begin using the Bioclear matrices with the interproximators.

I saw a patient today who had a 1mm diastema between the upper first and second molars.This was produced by a relatively small mesial marginal ridge fracture of the porcelain on a porcelain-fused to-metal crown on the second molar. I was interested in attempting an in-the-mouth repair using your system. Which materials (matrix and interproximator) would be suitable for this type of repair? Is there a description of the technique on the Bioclear website? Do you think these repairs are durable?

Thanks for your help.
Joseph Ritz, DMD
Wayne, PA



DR. CLARK'S RESPONSE:

Dear Joseph,

I have repaired several of these marginal ridge fractures and most have done well. (Including one on my wife!). The website or your DVD have a step by step in the "yellow" or porcelain section.

http://www.bioclearmatrix.com/Articles.asp?ID=170

Remember that many of these fractures may have been precipitated by marginal ridges that were either just too tall or were too "sharp" and were unsupported with a bit of a point contact. This stems from an under-contoured emergence profile in some cases, or a poor contact on the adjacent tooth that probably could have been smoothed or contoured at the time the crown was done. Make sure and address those to increase your chance of success.

Let me know how it goes and take some pictures if you can. Call technical support also with any questions.

Cheers,
David

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