Class IV #8 and #9
Posted on March 07 2017
Due to long standing decay the overlapped teeth have slightly collapsed into one another.
Greater Curve "Wide" in place
The mesial portion of the band is folding toward the prep. See next photo on how to achieve more band flare toward #9.
Optimal band flare toward #9
I achieved more band flare toward #9 by rotating the head of the retainer toward the teeth and securing the rotatation with Triad Gel.
Band cut back
Labial portion of band cut away for access.
Bonding agent placed
Etch and rinse enamel, Prelude SE bonding agent, Activa A2 is incremented throughout the entire prep with the exception of the mesial labial corner. I also placed Teflon tape to better shape the mesial emergence contour.
Filtek Supreme Ultra placement
Filtek Supreme Ultra A2 placed at the cervical and A1 completes the mesial incisal. The Filtek is overbuilt.
Initial shaping is done with the matrix left in place. Helps prevent gouging along the gingival border.
Ensuring equal width
Used a boley gauge to insure 8&9 will be equal in width. It is important to exit your stool and get face to face with your patient. This is the only way to make certain the midline is adjusted parallel to the long axis of the patient's face.
Greater Curve "Wide" placed around #9.
Matrix cut back
Mesial contact opening made in the matrix.
As done with #9, do your initial adjusting with the matrix left in place.
Final class IV's 8&9
Very important to do your final touch up facing the patient. Don't become a victim of a 10:30 positioned parallax view. Move from your comfortable stool and directly face your patient.
Activa is very strong. Bonds well to tooth and composite. It is flowable, so it is quick and easy to place. Activa is bioactive. These properities make it an excellent supporting material.