The individual matrix band.
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Compared to full crown temporization, direct autocured resin provisional technique for intracoronal onlay preparations is more complicated and less predictable. Clinical concerns include possible pulpal irritation, extra chair time for contouring proximal and marginal excess, and a critically short time constraint to remove the curing resin in the "rubbery stage" to avoid distortion or "locking" into the preparation. A two-step direct technique using two new light-cured provisional resins addresses these problems. First, a light-cured, elastic resin is condensed against the internal preparation walls and confined within a wedged metal matrix band. Then, using a clear template matrix, the elastic foundation is overlaid with a strong and esthetic light-cured provisional resin.
Overhanging margins of proximal restorations are a well-known, iatrogenic cause of periodontal pathology. The high incidence of such findings in Western societies should arose the concern of the dental community. However, overhanging margins represent only part of the iatrogenic problem created by the misuse of wedges in restorative procedures. Other causes include incorrect proximal contouring, inadequate contact points and under- or overfilling the restorative material. The understanding of the variables associated with wedge selection and positioning has a major role to play in the prevention of iatrogenic periodontal pathology associated with restorative procedures. It is concluded that: (i) the occlusion of the matrix band to the remaining healthy tooth structure of the gingival cavosurface line angle should be achieved solely by the correct application of the wedges; (ii) the effect of the wedges on the proximal contour and contact area should be carefully re-evaluated prior to insertion of the restorative material; (iii) various sizes and shapes of wedges and a sharp knife for carving must be readily available.
A technique for fabricating dies without using a die saw has been described. The technique saves the time consumed in sawing the dies and eliminates the hazards of using a die saw. It is particularly advantageous when little space exists between dies since the Zolnowski matrix band is thinner than the thinnest saw blade. The band can be easily placed in the tightest interproximal spaces and can be secured in place with a minimum amount of sticky wax. The technique can be used for crowns, fixed partial dentures, and indirect inlays.
The considerable decrease in microkeakage in the compound-reinforced restorations may be due to the tighter fit of the matrix band at the gingival wall of the preparation, which allows better condensation and marginal sealing of the restoration. The compound prevents lateral migration of the band during condensation pressures.
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Blast colony-forming cells (BI-CFC) and pre-colony-forming unit-granulocyte, monocyte (CFU-GM) in human bone marrow bind to marrow-derived stromal layers grown in the presence of methylprednisolone (MP+), but do not bind to stroma grown without MP (MP-). The BI-CFC bind to stroma and form colonies when overlaid with agar; the pre-CFU-GM bind to stroma and release CFU-GM into the supernatant culture medium (delta assay). These two classes of progenitor may represent similar stages of hematopoietic cell development. Their binding to stroma depends on the presence of heparan sulfate proteoglycan (HS-PG) in the extracellular matrix secreted by the stromal cells. Here, we have analyzed the functional and biochemical properties of HS-PG isolated from MP+ and MP- stromal cultures. HS-PG or isolated HS glycosaminoglycan (GAG) side chains partially blocked progenitor cell binding when they were added to the 2-hour binding phase of the BI-CFC or delta assays. Gel electrophoresis of HS-PG resolved more bands in matrix preparations from MP+ cultures than in preparations from MP- cultures. The blocking activity of the eluted MP+ HS-PG bands depended partly on the amount of GAG attached to the protein core and presumably partly on the structure of the core itself. Time course studies demonstrated that the HS-dependent phase of the binding interaction was limited to the first 30 to 60 minutes of the 2-hour binding phase. The different blocking effects of MP+ and MP- HS indicate that they have different biochemical properties. The HS-GAG in MP+ stroma has a higher degree of sulfation and a greater negative charge to mass ratio compared with MP- HS-GAG. Variations in HS may determine specific binding by hematopoietic progenitor cells and a heparan sulfate receptor is envisaged as acting in concert with further cell adhesion molecules (CAMs) on the progenitor cell surface.
Most techniques and devices described for crown removal, in one way or another, destroy the integrity of today's precision cast crowns. There were only three techniques described that do not require drilling a hole, cutting a notch or slot, clamping with claws or jaws, prying with instruments, or grasping with forceps and pliers. These are the copper band filled with cement, the coping of cold-curing acrylic resin, and the Richwil crown remover. The safest and least traumatic of all crown removal devices and techniques is to cut a slot and pry the crown loose. Although the crown is destroyed, damage to the tooth is avoided.