How do I get the resin in and pack it if the matrix is over the buccal and lingual aspects of the prep?

I have had quite good results so far from my trial anterior and diastema closure kits. One problem I have experienced is that once in place, the matrix blocks off the access for resin placement. I have bent it out of the way, but this sometimes runs the risk of disturbing the soft tissue /gingival seal or distorts the matrix. Any advice as to how to get the resin in and pack it if the matrix is over the buccal and lingual aspects of the prep?

Dr. Lisa Chong
3006 Bloor St. West
Toronto, ON M8X 1C2

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DR. CLARK'S RESPONSE:

If you are having access problems you can:

1. Place the paste composite indirectly by syringing it on the facial and or palatal, and then "patty cake" it into the interproximal with a flat composite instrument (I like our Bioclear/Hartzell titanium coated B6-7T "Composite Placing Instrument") and then you can bend the matrix less. I am doing that technique more and more. Place a small dollop of flowable first to eliminate voids. The flowable canula is small enough that you should be able to insert it directly under the teased matrix without excessive distortion of the matrix. The larger paste syringe creates a lot more matrix movement.


2. Cut back a small area of the flange that is blocking your access.


3. Have the assistant tease the matrix away with an explorer while you are placing material


4. Change mirror position


5. Use the Universal 10 mm matrices (Flat Universal 10 or Curved Universal 10). These are more "open matrices" with good cervical shapes.

I use all of the above, depending on the case.

Hope that helps,
David