Detail 1

  • Setup

    01. Greater Curve vs. Standard Tofflemire

    At the top is a standard tofflemire band.

    At the bottom is a Greater Curve tofflemire band.

    You will see that this technique of restoring teeth takes advantage of the peculiar properties unique to composite.

  • 02. Band setup

    Set up the band opening just larger than the circumference of the tooth.

    This will keep the band within the prongs of the tofflemire retainer as the matrix is tightened

  • 03. Tighten band

    You will notice that the band will pull very tight around the cervical, thus providing a better seal.

  • Prep

    04. Bend the band against the marginal ridges of the adjacent teeth

    Burnish the metal precisely at the contact position with a condenser.

    If necessary, prior to placing the band, make certain the opposing contact has a flat surface. If it does not have one, make one. A marble to marble final contact, even if tight is still a food impaction site.

  • 05. Finishing burs

    These are the Brasseler finishing burs you will need. Of course, it doesn't have to be Brasseler, but something similarly shaped.  

    The 7404 small football is the first choice.

    If the space is really tight, reach for the flame shaped MW 7901.  

    Many find that Shofu's FL2 White Stone works well.

  • 06. Plane away the matrix at the contact position

    Do not use water spray and go easy on the rheostat.

    Just barely remove metal - Keep the RPMs low with the bur against the matrix the entire time and do not lift the bur.  

    It is a "rubbing, smoothing in" side-to-side motion. Once you have perforated metal, expand the opening around the periphery until you have arrived at the desired contact size both buccal-lingual and cervical-occlusal.  Do not be heavy handed. Magnification makes this easy.

  • 07A. Shape the contact

    Pictured is a third molar removed from a 33 year old patient.

    Note how nature over time creates a broad oval contact.

    You will duplicate this with your composite.

    You have the ability to shape the contact to any size desired.

  • 07B. Assure the metal feathers against the adjacent tooth

    Double check to assure the metal feathers against the adjacent tooth without gaps around the periphery.

    The circumference of the opening is guided by the flatness of the adjacent tooth's contact surface.

    The opening does not need to be large.

  • 08. Place the flowable composite

    After placing the bonding agent of your choice, begin by placing a flowable composite. Curing the flowable composite will lock everything in place, and assure the deeper parts of the prep are sealed and bubble free.

    Only place flowable composite into the deeper crevices and sides of the proximal box. Keep it thin -  Remember, flowable composite has excessive polymerizing shrinkage.

    After placing the flowable composite, fill the remainder of the prep with composite.

  • Band Removal

    09. There is no need to place a separating agent at the contact areas

    Any bonded contact to the adjacent tooth can be broken cleanly with the blade of a small mixing spatula.

    Tell your patient they will hear a little snap as you lightly torque the spatula.

  • 10. Slide band out of contact area

    Band removal is easy. The band will usually slide out of the contact area. Hard to believe, but true!  

    If the band does not slide out easily, twist the band side to side. It will sever at the contact position due to the prior burnishing.

  • Completed Composite

    10A. Finish as normal

    Finish out the composite and adjust occlusion as you normally would.

  • 10B.

    Contacts will have depth as well as width, and will be very tight and smooth.

    No food impaction here!

  • Additional Information

    Sealing the contact opening

    There are times the contact opening within the metal band will not seal perfectly against the neighboring tooth. Use a condenser to hold the matrix band against the neighboring tooth at the base of the contact area, and above the first increment of flowable composite.

    The thinned metal is very malleable. It is easy to hold in position while curing the flowable composite.

    The arrow shows the position for the condenser.

  • Wedging

    Wedges rarely need. Your contacts will be tight without wedging.

    If there is a need to secure the matrix against the cervical portion of the prep, lightly place a wedge.

    Trim the belly of the wedge (pictured left) so it does not distort your beautifully shaped matrix.