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.

4 comments

  • Victor: September 29, 2019

    Greater curve bands are far better and cheaper than David Clarks exotic Bioclear bands.The teeth tend to look more squarish and need a lot of adjustment. Just my view…

  • Kim Scott: April 15, 2019

    Sometimes everyone tries to be diplomatic.
    Who is Nathan Mayo who thinks Clark Bioclear is better?
    Let’s see. Greater curve simple inventory, low cost, simple technique, no subgingival flash. Or,
    Bioclear.
    Large costly inventory, ordering constantly,
    subgingival flash difficult to control with a plastic matrix, high cost, technique is very difficult and depends on flow/high resin low filler. Sounds like a plan. I know we go to Dr. Clarks seminar for points and my partner bought some of his matrices but after he gets frustrated he never uses them and they sit in the cupboard. And I end up doing the fillings.

  • Tracey : April 10, 2019

    This works really well for me when the class IV is even deeper. I can keep these and class VS dry and uncontaminated.

  • Nathan Mayo DDS: April 09, 2019

    Very nice end result and I like the idea of the burnishing of the brass………however, I think your devotion to the Greater Curve works against you sometimes. Clark’s Bioclear matrices work extremely well for this kind of stuff. Just because Greater Curve CAN do something does not always make it the best choice

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