Editor’s Note: This blog was authored by Dr. Brett Richins, a full-time practicing dentist in the Salt Lake City, Utah, area. Dr. Richins also works part-time as a member of Ultradent’s in-house clinical team.
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As dentists, we are constantly faced with restorative challenges related to variations in anatomy, misaligned or missing teeth, and/or extensive missing tooth structure. There are countless solutions and tools available to help us achieve predictable and exceptional results for our patients. There are times when selecting the best matrix system for a specific situation will make restoring a tooth much easier and will help us achieve our best possible outcomes. Two of the main categories we can choose from as restorative dentists are circumferential bands (like the Omni-Matrix™ retainer and matrix band) and sectional matrix systems (like the Triodent® system). Criteria for selecting the best system for a specific case can include size of the restoration, location and number of surfaces being restored, presence of adjacent teeth, accessibility, alignment of teeth, long-term plan for the tooth, and personal preference.
Triodent V3 Ring
Omni-Matrix Disposable Retainer and Matrix
Most of us have a go-to process and have become comfortable with a specific system. I have personally learned over the years that there are times when my tendency to always reach for the same tools can make my job more difficult than it needs to be. Sectional matrix bands have become a staple in many dental offices because of the ability for dentists to quickly and efficiently achieve excellent contours, ideal contacts, and well-adapted margins.
There is a learning curve when using a new system, and it is common to want to stick strictly to what we know. When I became comfortable with sectional matrix systems, I unintentionally left circumferential bands behind and never looked back, until I learned about Omni-Matrix bands. There are many situations where I personally have found circumferential bands to be superior and I have changed my approach when starting a restoration. Now, the first thing I do is look at the case holistically and decide what type of matrix system I feel will work best.
3D rendering of a Triodent band.
Sectional matrix systems are my personal go-to when doing a typical Class II restoration with well-aligned adjacent teeth and no missing cusps or extensive missing tooth structure. With a well-designed sectional matrix system, these types of typical cases can be a fast, predictable way to achieve ideal outcomes. However, if we don’t have circumferential bands as one of the tools in our toolbox, it is easy to find ourselves in a frustrating situation that could be avoided.
I personally have some common situations where a circumferential band will be my go-to solution. One of the most common reasons I will prefer a circumferential band is when there is no adjacent tooth or when I am restoring the buccal or lingual surface of a tooth. As a young dentist that was excited about sectional bands and had tunnel vision, I would often find myself rebuilding these teeth “freehand” without any matrix system. A circumferential band can help me quickly and easily place a restoration and keep it confined to the intended area.
Seating an Omni-Matrix Disposable Retainer. Removing an Omni-Matrix Disposable Retainer.
Another situation in which a circumferential band can be helpful is when the patient has a missing cusp. This is a situation that often can be done with a sectional matrix, but it may result in an under-contoured restoration if there is not adequate tooth structure to support the ring. Pediatrics can also be a great indication for a circumferential band, as placing a sectional band on a primary tooth can often be difficult and the contours are not as critical. Whereas, a circumferential band will usually be more stable on a primary tooth and can be more efficient when restoring an MOD.
About Dr. Richins:
After earning his bachelor’s degree in biomedical engineering from the University of Utah in , Dr. Richins received his doctorate from the University of Pittsburgh School of Dental Medicine in . He is a member of the Academy of General Dentistry, the American Dental Association, and the Utah Dental Association. He continues to pursue his education and frequently attends advanced courses that cover topics such as Endodontics, Implantology, Cosmetic Dentistry, Oral Pathology, TMJ, Sleep Apnea, and much more. He has also done humanitarian dentistry in underserved areas of Jamaica, Vanuatu, and Appalachia. In addition to practicing dentistry, Dr. Richins spends one day a week working as a Clinical Advisor for Ultradent Products. Ultradent has been developing and manufacturing the highest quality dental products for over 40 years. Dr. Richins’s role at Ultradent allows him to be involved in testing and developing the latest dental products.
A dental matrix is a band that adapts to the surface of the tooth to be restored and reproduces the anatomical contours, replacing the missing wall or walls and containing the restorative material to give it a anatomical shape to the interproximal walls and obtain adequate contact points.
Sometimes choosing a matrix band is not an easy task and that is why in this article we want to tell you how you can select the most appropriate one for each of your clinical cases and what are the factors to consider in your choice. Are you ready?
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The use of matrices in dentistry
The use of matrices in dentistry allows teeth to be reconstructed according to their original morphology, maintaining their shape, contour and contact points, in order to preserve their function. This important work is carried out by restorative dentistry, which over time has invested its efforts in the development of new techniques and materials that facilitate this task. Among these developments we find the matrix systems, which we will talk about in this article. But first things first.
Why are touchpoints important?
The interdental or interproximal area, that is, between tooth and tooth, is formed by the contact area or relationship, the interproximal niche and the interdental papilla that occupies this space in the form of a triangle. The contacts between the teeth, called interproximal contacts, have the function of protecting the soft tissues and when they are not present, food packing occurs that damages the gingival tissues, causing diseases such as gingivitis and periodontitis. In addition, a correct contact between the teeth favors the stability of the arches through the combined anchorage. So how can we get functional contacts and contours? Dental matrices are the solution.
What are the functions of dental matrices?
- Preserve the restorative material, preventing it from spilling over.
- Restore the anatomy of the tooth, helping to reconstruct its contact relationship and the lost contour.
- Restore the biological function of the tooth and protect the supporting tissues, avoiding injuries.
- Contribute to the surface finish, achieving a non-retentive surface for plaque or food debris.
- Reduce the probability of secondary caries.
- Increase the useful life of composite restorations.
- Protect the neighboring tooth during a cavitary preparation procedure.
Types of dental matrices
There is a wide variety of types of dental matrices on the market that we can classify according to:
- Material: Metal matrices made of steel, bronze, titanium, etc. or plastic matrices such as acetate or celluloid, which, although less resistant, allow the passage of photopolymerization light.
- Materialization : Universal matrices manufactured in a standardized manner such as Tofflemire matrices or individual matrices that are made by the dentist on a case-by-case basis, for example, individual Hollemback matrix.
- Manufacturing: There are shaped matrices that cannot be modified due to their elastic memory and, on the other hand, there are laminated matrices that can be modified to improve the contour and the point of contact.
- Adaptation system: There are matrices that do not require a matrix holder and do not lose their stability and rigidity and others, on the other hand, do need a matrix holder for proper adaptation.
What should a dental matrix ideally look like?
- It must be rigid, in such a way that it allows its proper insertion in the interproximal areas.
- It must be compatible with the restorative materials, for example, you must be careful with the chemical incompatibility of materials such as celluloid matrices, which can inhibit the setting reaction of acrylic resins. You should also pay attention to physical-chemical incompatibilities, as in the case of some adhesives that can adhere the restorative material to the matrix, preventing its subsequent detachment without removing the filler material. Therefore, it is necessary to pack the inner side of the matrix to avoid this problem.
- It should be easy to adapt to the contour of the tooth, this functionality is linked to the flexibility of the dental matrix to envelop the tooth with the minimum amount of pressure.
- It must be able to contour and be flexible, this will facilitate its perfect adaptation to the edges of the restoration.
- It must be resistant to condensation pressure, that is, it must not slip and must remain in the place where we have placed it.
- It should be easy to remove and have the minimum thickness to avoid excessive separation between adjacent teeth.
Dental matrix systems
You probably know many dental matrix systems and are using one or two of them. Next, we will talk about some systems, from the most common and well-known to other more innovative ones that you may not know yet and are worth trying. Do you dare?.
Tofflemire Matrix Holder System
As you can see, we start with a classic. This universal matrix system was created by Dr. Benjamin Franklin Tofflemire in and is still in use today. The Tofflemire system is indicated to restore interproximal surfaces, class II cavities and mesio-occluso-distal (MOD) cavities, in both permanent and deciduous posterior teeth.
It has several advantages, among which we can mention the possibility of using matrix bands of different widths, it can be separated from the band before removing it, it can be used with curved bands and, in addition, it can be It can be positioned both vestibularly and palatally.
Medicaline Tofflemire universal matrix holder
Garrison Composi-Tight 3D Fusion Sectional Matrix System
Do you have difficult class II cases? The Composi-Tight 3D Fusion Sectional Matrix System could be the ultimate solution for predictable results and we'll tell you why.
The Composi-Tight 3D Fusion sectional matrices provide tight and perfect contacts thanks to their advanced design, in addition this system has rings with Soft Face technology to fit the extra-soft matrices to the contour of the tooth to help you perform a perfect restoration without the matrix moves out of place. This Garrison matrix system is highly intuitive and easy to use, with features that will make your job easier and more efficient.
Composi-Tight 3D Fusion Firm Matrix: Garrison Sectional Matrix Kit
Garrison Strata-G Sectional Matrix System
Garrison's Strata-G Sectional Matrix System provides an anatomical 270º Seal that prevents burrs and over-contoured margins.
The Strata-G system has been specially designed for the creation of perfectly anatomical and narrow contact points in class II composite restorations. The sectional matrix bands ensure the reconstruction with the proper anatomy on the tooth, while the three models of rings create the necessary separation between the teeth for the adaptation of the bands, obtaining as a result a natural and close contact.
Strata-G: Garrison Sectional Matrix Kit
Ultradent Halo Sectional Matrix System
The Ultradent Halo sectioned matrix system provides an ideal separation between the teeth, thanks to the design of its ring that fits with high precision and the wedge that provides an active and always careful separation with soft tissues. In addition, the bands are perfectly designed to give the tooth a natural contour, thus providing uniform and precise contact points.
Perhaps the most distinctive advantage of this innovative matrix system is that the wedges are active, that is, they work by separating the teeth in a comfortable way for the patient. Another interesting advantage is that the ring of the Halo system is universal, this means that you only have to use one ring for both molars and premolars.
Halo Sectional Matrix System: Ultradent Original Band Kit
In conclusion, making a good point of contact is a difficult task and remains a challenge for today's restorative dentistry, but fortunately in our times we have matrix systems very capable of achieving them and which have surpassed the classic Tofflemire matrix holder, which has the drawback of generating axial emergence profiles that are not very anatomical, straight and difficult to improve.
The sectional matrix systems are a great alternative, which, although they have a higher cost, are also their benefits, since they allow a better fit in interproximal spaces to achieve a better point of contact. contact and a more natural and anatomical contour.
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