Help with using palodent for class 2 composite restoration

[predent1891]

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Hello SDN, I need help with a class 2 MO OL composite restoration on an ivorine tooth. I must make sure not to damage the ivorine tooth which is really hard for me. The hardest part is applying the palodent. When I apply it, there always seems to be a gap between the matrix and the gingival floor of the box, resulting in excess.

When I wedge the teeth apart and try to remove the excess with soflex discs, it just results in the ivorine tooth being sanded down noticeably or contact being lost. It is also hard to go back in with composite polishing burs because they wont fit between the teeth. Therefore, I think I really need to learn how to perfectly apply this palodent.

So can anyone give me advice for applying the palodent?

Also, is it better to overbulk the occlusal part or put the minimum possible? I am also having problems cutting down the excess with composite polishing burs without cutting down the ivorine tooth.

 

[DocSwole]

Hey there, I've been doing alright with the palodent and composites so here is my opinion.

1. Use a matrix that works. In my kit there are at least 3 types and I feel like some might be too short for some teeth. I use the ones with a bit more length to make sure it spans the entire height of the tooth.
2. You use a ring, right? If so make sure your order of doing things is right.
I believe it should be, place matrix, place wedge, make sure the wedge is tight against the matrix, place ring, readjust the wedge (push it in more to make it tight since the ring will push the teeth apart).
3. I would never use disks or burs to smooth out excess flowing out of the gingival floor. You'll destroy the contact which is the worst thing you could do. Disks and burs can be used to smooth out the occlusal and the sides.
If you've cured your composite and you notice your explorer catches on an overhand below the contact point, I would suggest using hand instruments to try to smooth it out. Either that or those strips that you can thread between the teeth.

As for the occlusal, it's best to get the shape perfect before you cure it.
But I suppose it's better to have a bit more that you can shave down than not enough.
For the occlusal I use disks but mostly a diamond football shaped bur.

edit: also, it's hard to put this all in writing, especially since I'm terrible with the terminology lol. When you have class you should ask a bay instructor to show you how to deal with these concerns, they are there to teach and you pay a lot of money for their input. Use it.