Predictable, Tight Contacts with Palodent® Plus Simplify Class II Restorations
The problem with Class II composite restorations, which account for an estimated 45% of procedures performed in general practices, is that they can be time-consuming and unpredictable, laments Stephen D. Poss, DDS. The Brentwood, TN, GP says that these very common procedures can cost busy practitioners like himself both time and money.
To help “take the dread out” of performing these procedures, Poss has for several years now been using the Palodent® Plus sectional matrix system from DENTSPLY Caulk, which he says makes the process of Class II restorations faster and more predictable. “With shrinking reimbursements, time and accuracy are critical, so finding an easier, faster, more repeatable way of doing things is what it’s all about.”
Compared to conventional Tofflemire-style matrix systems, which Poss says he “grew up on” and that are still used by many of his colleagues, the Palodent® Plus matrix provides tighter contacts, a more secure seal, and the ability to easily perform multiple restorations while minimizing flash and finishing excess. The system’s ease of placement, he notes, is its number one advantage. “It’s nice to know once you place the system correctly, you will get good, positive results,” he comments.
The Palodent® Plus system comprises a universal ring and narrow ring to accommodate molars and premolars, various sizes of matrix bands, wedges, and WedgeGuards, forceps for placing the ring, and pin tweezers to lift, transport, and manipulate the matrices, wedges, and WedgeGuards. Unlike tofflemire type systems which require a forced wedging technique to create the interproximal separation needed, the ring of the Palodent® Plus system does the separating. The practitioner can even place the ring while waiting for anesthesia to create initial separation and make it easier to place the WedgeGuard or matrix interproximally. Poss prefers to use the thin metal WedgeGuard prior to placing the sectional matrix; the guard protects the adjacent tooth while preparing a tooth or removing amalgam.
In addition to achieving consistent accuracy of the contacts and contours with this trusted system, which, Poss says, makes the need to repeat the procedure rare, clinicians also save time on cleanup and finishing. “Because of the way the clamp fits over the sectional matrix, there is less flash or excess material to clean up and less finishing, saving me even more time.”
Poss utilizes three additional DENTSPLY products to complete restorations with the matrix in place, including SureFil® SDR® flow self-leveling bulk-fill flowable base material, which enables him to place 4 mm of material at a time. “Because it is self-leveling, the composite has the ability to flow into the corners of the Class II restoration toward the gingival area and obtain a good seal.” The next step is light-curing with the SmartLite® Focus® curing light, which has a collimated beam that can cure reliably even at 8 mm distance from the light tip. “This complete cure all the way down to the floor of the proximal box achieves the polymerization needed to have a nice, solid filling,” he explains.
His final step is placing TPH Spectra® as a finishing composite, which Poss says provides an esthetic polish to complete the procedure. “Now, unless it’s a deep Class II, I can get the restoration almost completed with one layer of SureFil® SDR® flow and a thin layer of finishing composite over the top of that.”
Poss finds the Palodent® Plus system easy to work with and is now well accustomed to using it. The company, he notes, provides ample support for clinicians who are new to the system or to other DENTSPLY Caulk products. “There are online videos and a tremendous amount of continuing education vehicles on their website (www.class2restorations.com), including live cases, so new users can get visual support to help them feel comfortable with Palodent® Plus, along with SureFil® SDR® flow and TPH Spectra®,” he says. Moreover, he adds, the sales representative in his area is fully available to provide information and help if needed.
“As dentists, we’re always looking for methods and materials we can depend on to get the job done right the first time, because redoing things is a very expensive process,” Poss comments. “The Palodent® Plus matrix system is straightforward and reliable. I can’t imagine using any other system.”
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