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Lower Class IV composites are difficult

Posted on April 04 2019

Introduction:

Lower Class IV's can be demanding. Positioning a matrix correctly is tricky because forming both an emergence contour and an anatomical tight contact is unpredictable. The Greater Curve bands address these problems.

 

Before

Step 1

Will restore #24 and #25.

Prepped

Step 2

Placed lots of enamel taper on #24.

Greater Curve Wide Brass setup

Step 3

The brass is malleable with no bounce back memory.

Band trimmed back

Step 4

Brass band trimmed along the labial and through the mesial contact. The emergence contour is burnished against the distal of #23. The mesial contact of #24 will be a direct composite build against #23. The brass is malleable and retains the burnished shape. The band provides a well defined surface to properly shape the composite.

Composite placement for #24

Step 5

Sequence of composite placement: Clean and Boost (Apex Dental), Etch enamel and rinse, Futurabond DC (Voco), Increments of Activa A2 (Pulpdent) provides the base followed by a labial layer of Filtek Supreme A2. I like the bioactivity of Activa and it makes a great dentinal layer for the Filtek.

Final

Step 6

Final Class IV #24. Final incisal composite #25.

Conclusion:

Using Activa and Filtek combination allows the dentist to fill the prep very quickly. The Greater Curve provides excellent isolation.