Dr. Gaurav Garg ( M.D.S.) Lecturer, College of Dentistry Al Zulfi, M.U. Asalaam Alekum Date: 18/11/2014

Contents  Matrix placement  Wedge Insertion  Insertion & condensation of Amalgam  Carving  Finishing & Polishing  References & Suggested readings

Matrix Placement  It is essential to use a matrix for Class II amalgam restoration  Following matrices systems can be used:  Tofflemire(Universal) Matrix  Sectional matrix ( Eg: Palodent)  Automatrix

Contouring of matrix band Correct or incorrect facial and lingual embrasure form is determined by the shape of the matrix strip.

Extension of matrix band  Occlusal extension: it should extend 1 to 2 mm occlusal to the adjacent marginal ridge.  Gingival extension: 1 mm apical to the gingival margin.

Wedge Insertion  Indications for round toothpick versus triangular (i.e., anatomic) wedges:  A, As a rule, the triangular wedge will not firmly support the matrix band against the gingival margin in conservative Class II preparations (arrow).  B, The round toothpick wedge is preferred with these preparations because its wedging action is nearer the gingival margin.  C, In Class II preparations with deep gingival margins, the round toothpick wedge will crimp the matrix band contour if its diameter is above the gingival margin.  D, The triangular wedge is preferred with these preparations because its greatest width is at its base.

Insertion & Condensation of Amalgam  Choose condensers that are best suited for use in each part of the tooth preparation and that can be used without binding  With amalgam carrier, first fill & condense amalgam in the gingival 1 mm (approximately) of the proximal box  First condense amalgam Gingivally followed by Proximal margins and then Mesial & distal side with gingivally directed pressure to ensure proximal contact  Continue the procedure of adding amalgam and condensing until the amalgam reaches the level of the pulpal floor

Insertion & Condensation of Amalgam  condense amalgam in the remaining proximal portion of the preparation concurrently with the occlusal portion  Overpack by at least 1 mm  Condensation should be accomplished in 3 to 4 minutes  Before carving, Precarve burnishing of the occlusal portion with a large egg-shaped or ball burnisher should be done

Carving of Amalgam  With the matrix band still in place, carving of the occlusal portion should begin immediately after condensation and burnishing with suitable carvers  Carve the marginal ridge confluent with the tooth's anatomy and duplicate the height and shape of the adjacent marginal ridge  Define occlusal embrasure using explorer tip  Then carve remaining occlusal portion

Carving of Amalgam  Remove matrix band & complete carving  Remove a possible small amount of excess amalgam at the proximal facial and lingual margins at the faciogingival and linguogingival corners and along the gingival margin  Once the carving is completed, the occlusion is assessed.

Proximal contour Proximal contour: A, Correct proximal contour B, Incorrect marginal ridge height and occlusal embrasure form C, Occlusogingival proximal contour too straight, contact too high, and incorrect occlusal embrasure form

Finishing & Polishing  Amalgam restoration should be finished & polished after 1 day

Amalgam Condensation

Carving

References & Suggested reading  Sturdevant's art & science of operative dentistry Theodore M. Roberson, Harald O. Heymann, Edward J. Swift, Jr.  Principles of operative dentistry (2005)- A.J.E. Qualtrough, J.D. Satterthwaite, L.A. Morrow and P.A. Brunton.  Fundamentals of Operative Dentistry- 2 nd Edition- Summitt & Robbins