Getting a Class III contact

[TXftw]

Hi all,
I have my cdca class III and II live patient boards coming up. I’ve not been able to consistently get firm, broad contacts on class III restorations. My contacts are barely closed and do not resist floss very much. The technique I currently employ is using a Mylar strip wedged between the papilla and the tooth im restoring. I always try to put my wedge carefully between the papilla and tooth in question rather than just sticking it between the 2 teeth without caring how it is positioned with relation to the papilla. I also try to make sure I’m not pulling the composite away from the adjacent tooth with the Mylar strip while I’m curing. Please let me know what I’m doing wrong and how to improve!

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[Humbl3Pye]

Hi all,
I have my cdca class III and II live patient boards coming up. I’ve not been able to consistently get firm, broad contacts on class III restorations. My contacts are barely closed and do not resist floss very much. The technique I currently employ is using a Mylar strip wedged between the papilla and the tooth im restoring. I always try to put my wedge carefully between the papilla and tooth in question rather than just sticking it between the 2 teeth without caring how it is positioned with relation to the papilla. I also try to make sure I’m not pulling the composite away from the adjacent tooth with the Mylar strip while I’m curing. Please let me know what I’m doing wrong and how I can improve!

What type of wedge are you using? I’ve found plastic wedges (the kind that break away) are helpful because they don’t compress/degrade as much when contacting saliva. Place your Mylar first, wedge (try going from the facial) and make sure you see a little bit of separation between the teeth. Check to see your Mylar strip is in snug and firm, then start your process (etch, rinse, bond etc). Build out your restoration until it contacts then gently fold the Mylar over and cure. You may need to refine w/ a 7901 bur to contour. Seems to work pretty well. Also try to keep as much of the existing contact in your prep as you can.

 

[Ivy.ch]

I grab a bunch of wooden wedges and try to find the largest that gives a good contour. Don't be afraid to really shove it as hard as you can with the backend of an instrument.

 

[TXftw]

I’ve been using wooden wedges. This last time I think I could’ve used a bigger sized wedge. I’ll try to acquire some plastic wedges for CDCA.

 

[oralcare123]

In my opinion you may be pulling Mylar strip when folding. Wedge and don't fold the strip

 

[TXftw]

@oralcare123 so you’re saying don’t wrap the strip around the tooth when curing? Just use the strip to avoid bonding to the adjacent tooth and not to contour the restoration of the tooth ?

 

[P7898]

I do biggest wedge and fold over but not a hard fold over. Pull through method sucks and is not reliable. I gently fold it withe the biggest wedge to get that contour.

 

[oralcare123]

@oralcare123 so you’re saying don’t wrap the strip around the tooth when curing? Just use the strip to avoid bonding to the adjacent tooth and not to contour the restoration of the tooth ?

Fold, but don't pull

 

[apicalforamen]

You can also pre-wedge (place prior to prepping)...give the PDL more time to adjust itself and compensate for thickness of Mylar strip.

 

[babs90]

Wrap sterilized teflon tape around tooth adjacent to your prep. Restore as usual, shape the composite with a carver or plastic instrument for proper contour. No mylar strip or wedge necessary with this technique.

 

[Bis-GMA111]

try using a sectional matrix band to give you a better contact

 

[P7898]

Flowable.