[Manual matrix method].
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The authors, as a sequence of a previous research, dealt with a morphological study, by means of level curves, of the lower first molar (mesial surface). This study based on dental amalgam reconstructions used two different types of interproximal cavity preparations; one type was related to the modern or conservative preparation and the other was related to the conventional cavity preparation. Two types of matrix holders were utilized as well as copper rings. In this project the contacting interproximal areas and adjacent structures were observed stereophotogrammetrically. As in the previous study, the models used were obtained from patients with good occlusal anatomical functional conditions and mounted in a semiadjustable articulator. The procedures for restorations followed the prescribed technique for these cases as far as the selection of the material, placement of the matrices, condensation pressure, etc, were concerned. The reconstruction of the serial slices, through level curves, were able to show the location of the contacting area for each matrix used, although it is necessary to stress that the original tooth contour has never been restored.
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When it is necessary to place casting margins subgingivally, it is important that they not violate the biologic width. A technique utilizing nonmedicated retraction cord during preparation is described which has several advantages. It results in bloodless, trauma-free tooth preparation and concealment of the metal margin without biologic width impingement or gingival recession. A resilient, unattached gingival margin free of inflammation is critical for the success of this technique. The physical and chemical properties of healthy gingival collagen and ground substance are briefly discussed along with the disadvantages of using this technique in the presence of gingival inflammation.
Comparing several clinical methods for making temporary crowns and bridges the matrix method has proven advantageous. The clinical and technical-laboratory working procedure is described. Using this method three temporary resins for crowns and bridges (Protemp, Dentalon plus and Scutan) were evaluated and compared concerning clinical usefulness.
The coordination of perceptive tissue management, diligent tooth preparation and prudent selection of the impression material for specific clinical conditions ensures the success of cast and ceramic restorations. The introduction of a knitted cord (Ultrapak with Astringedent) has alleviated the arduous aspects of tissue displacement and the new impression materials have displayed exceptional accuracy but healthy tissue is fundamental.
The surface quality of 2 composite filling materials (Adaptic with coarse hard quartz fillers and Cosmic with fine softer glass fillers) was evaluated using profilometry, scanning electron microscopy and light reflectometry after finishing with experimental diamond discs, 3M discs, corundum discs, polishing paste and also after sealing. Plaque formation on standardized surfaces of both composites was photographically recorded in 20 subjects. The sealed surfaces and the surfaces finished by the matrix alone were approximately 10 times less rough than after finishing procedures. Under in vivo conditions they reflected the most light, for both composites. The sealer failed to cover the whole composite surface. The unfinished and sealed surfaces lost their shine 3-7 days after placement in the mouth. Decrease in reflectance was independent of mechanical oral hygiene procedures. There were no significant differences in the roughness produced by the various discs on Adaptic surfaces. Diamond discs with particle size 1-3 micrometer resulted in least surface roughness and were the only instruments not destroying the filler particles of either composite. 3M discs and the rough corundum discs caused significantly more surface roughness of the Cosmic surface. Reflectometry showed that the finishing methods unfavourably affected composite surface smoothness. Among all finishing methods polishing paste produced the highest reflection value on the Cosmic surface. Adaptic surfaces were always associated with more plaque formation than Cosmic surface after all finishing methods.
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The polymerization of Evicrol, like that of other composites, is adversely affected by atmospheric oxygen. This negative effect may be avoided by the use of matrices. On filling class V cavities, the utilization of well adaptable cellophane, aluminium and tin foils is justified. To obtain satisfactory results in final polishing, it is necessary to employ polishing disks suited for polishing the anorganic fillers contained in this restorative plastic.
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