1. Class II Restorations Dr Jamal Naim Dean of the faculty of dentistry
University of Palestine/Al-Zahra City

2. Bite Wing X-ray

3. MO, OD, MOD

4. Restorative techniques
There are several different restorative techniques available to the clinician.
We will discuss two options.
Amalgam Filling
Composite Filling

5. Gaining Access

6. Depth

7. Outline

8. Proximal Caries

9. Outline
Bur # 330

10. Caries removal Clean DEJ and remove infected dentine.
Size of bur determined by extent of caries

11. Proximal Box Preparation
Preparation of gingival seat, buccal and lingual walls and axial wall of the proximal box

12. Proximal Box Preparation
Adjacent tooth protection with matrix band

13. Proximal Box Preparation
Extent buccal and lingual walls of proximal Box so margins lie into self cleansing areas

14. Proximal Box Preparation
Don’t leave unsupported enamel
Gingival seat parallel to occlusal surface

15. Proximal Box Preparation

18. Caries removal
Line dentin with adequate base material (zinc phosphate cement or GIC)

19. Matrix Band Apply matrix band Apply wedge from palatal side
Burnish contact area

20. Review cavity
The cavity must be checked for the followings before manipulation of amalgam
Adequate self-retention.
Proper resistance.
CSA 90.
No caries, debris or moisture.
Pulp is protected with cavity varnish, linear or base material depending on the cavity depth.
Proper matrix is fitted.

21. Restoration Transfer amalgam to cavity in increments
Start with proximal box

22. Restoration
Condense amalgam thoroughly
Use largest possible plugger

23. Restoration Overfill the cavity
Separate amalgam from the matrix with a probe

24. Restoration Carve with half hollenbach carver
Carve from tooth to filing following the margins
Don’t over carve

25. Matrix removal

26. Matrix removal
Remove the wedge
Remove band first distal then mesial

27. The gingival margin is then checked for any over hanged margin of amalgam using sharp probe and also carving of the gingival embrasure if needed.

28. Finishing
Complete carving
Burnish all possible areas

31. Finishing
The patient is then instructed not to use this side for the next 24 hours to avoid cracking or fracturing of the restoration.
Also the patient should be advised to come after 24 hours for finishing and polishing of amalgam.
Why?
After 24 hours of carving to avoid disturbing crystallization of amalgam.

32. Finishing and polishing
Aims:
1. Removal of any premature contact, marginal flashes or marginal over hangs.
2. Provide a lustrous homogenous amalgam surface.
Advantages:
1. Increases corrosion resistance.
2. Decreases bacterial plaque retention and liability to recurrent caries.
3. Minimizes gingival irritation.
4. Improves strength of amalgam, as it removes the surface irregularities that act as stress concentration areas.

33. Finishing and polishing
Technique:
Finishing:
Using finishing bur in a direction from the tooth to restoration.
Using sandpaper discs for accessible surface.

34. Finishing and polishing
Technique:
Polishing:
Using pumice with brush or rubber cup.
Avoid heat generation, as it will lead to attraction of Hg to the surface resulting in:
a) Weakening of the surface.
b) Weakening of the bulk due to the formed porosity.

35. Matrix Bands
Matrix: That which contains and gives shape and form to anything.
Dental matrix:
A piece of metal or non-metal, which gives form and support to the restoration during packing and hardening.
Used only with direct restorative materials, which are packed into the cavity in the plastic form.

36. Matrix Bands

37. Tofflemire Matrix band

38. Tofflemire Matrix band

39. Function of matrix
Serves as temporary wall or walls during condensation of plastic materials packed into compound or complex cavities.
Gives form and shape to the restoration especially in contact area.
Maintains this form of the restoration until it hardens.
Prevents gingival marginal overhangs.

40. Wooden wedges
The matrix band should be properly supported with a wedge to provide adaptation of the band on the gingival floor and prevents marginal overhangs.

41. The cavity should be properly matriced and wedged before manipulation of amalgam.

42. Management of Matrix band

43. Management of Matrix band

44. Management of Matrix band

45. Management of Matrix band

46. Management of Matrix band

47. Management of Matrix band

48. Matrix band application

49. Matrix band application

50. Matrix band application

51. Matrix band removal

52. Matrix band removal

53. Hawe Matrix

54. Videos