The below case was completed and documented by our guest presenter, Dr. Ahmad Fayad. This is a great example of a Greater Curve band and technique at work!
Introduction:
In the economy down turn I am being faced with more and more of these larger restorations... Most of these people can't afford crowns... So what do you do? Crown or bullet in the tooth? How would you like to be treated if faced with a scenario similar to this? There should be an alternative other than letting it fail slowly! I think these large monster composites have a place in Dentistry today.
Before
Step 1
16 Large composite with asymptomatic RCT - Reccurent caries. Recommended crown, Patient denied.
Prep
Step 2
After caries and composite removal, had to cut down the palatal cusps… Ready for the greater curve matrix band.
Greater Curve Band in place
Step 3
Greater curve in place and window holes drilled by a finishing round diamond (Thanks Karim for that tip it makes the window much smoother!)
Band removal
Step 4
Composite in place - doesn't look good yet… No attention to occlusal anatomy or detail yet... (Xtra base U- Filtek supreme A2)
Band cut back
Step 5
I get asked these questions a lot: Doesn't the composite bond to the adjacent tooth? And how do you remove the matrix band?
Q1: Yes the composite does bond to the adjacent tooth ... Big deal? No.
Q2: I place my matrix forceps on the band and force the band laterally on the tooth in a upward motion, you here a SNAP, that is when you have broken the bond in the window that you created and now you have a nice tight contact.. It is very simple to do.
Occlusal anatomy
Step 6
Occlusal anatomy by 557 burs, shoufo white dura stone, soflex disc are essential.
Palatal cusps reduced
Step 7
Intraorally
Step 8
Nice tight contacts
Step 9
Post op Radiograph
Step 10
I dont like the RCT, but it doesn't bother her...
