Lower Class IV composites are difficult
Posted on April 04 2019
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.
Will restore #24 and #25.
Placed lots of enamel taper on #24.
Greater Curve Wide Brass setup
The brass is malleable with no bounce back memory.
Band trimmed back
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
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 Class IV #24. Final incisal composite #25.
Using Activa and Filtek combination allows the dentist to fill the prep very quickly. The Greater Curve provides excellent isolation.