Quadrants of posterior composites worry dentists because of difficulty obtaining quality contacts, potential sensitivity, and placement efficiency. Rubber dam isolation was done for restorations in #12 through #15.
Initial access was done with a 330 carbide bur.
A caries indicator (Sable Seek, Ulradent) was used to help identify areas of affected dentin.
Decay was completely removed with a spoon and #6 round bur and a deep bevel was placed on all enamel for increased enamel etching surface and to blend the color of composite better with tooth.
After complete decay removal, a bio-regenerative liner (TheraCal, Bisco) was placed over the deepest parts of the preps to stimulate dentin repair and to decrease potential sensitivity.
When there is less than 2mm of separation between the adjacent preparations, back-to-back restoring should be considered. In this case Pinch Matrices were placed on the first bicuspid and molar and tightened. These feature a blue mylar and an attached tension retainer that is “pinched” securing it to the tooth. Slick Band sectional matrices are then placed on adjacent restorations and held in place with wedges.
The two bicuspids are etched, rinsed, and dentin bonding agent placed followed by composite. The sectionals are left in place for molar filling.
The rings are removed from the bicuspids and 3D and G rings placed mesial and distal to the first molar. The molars are selectively etched, rinsed, and dentin bond agent placed.
To ensure a tight contact a bulk fill flowable was placed in one proximal box at a time and the mylar held against the adjacent tooth with a “PerForm” proximal contact instrument. This ensures that the contact is tight and well-formed while light curing though it.
The bulk fill flowable is covered with a microhybrid composite and all rings, matrices, and wedges removed. Shaping was done with round and pointed finishing burs.
The final result is an efficient placement of a full quadrant of composites. The rings and matrices from Garrison allow broad, deep, and dependable contact to be made simply.