restoring contact and contour classification

contacts and contour

1. Presented by
S
onal bansal
Pg student
D
epartment of conservative
dentistry & endodontics
RESTORING CONTACT
AND CONTOUR


PRESENTED
BY
DR.SONAL
BANSAL

2. INTRODUCTION
From the cariogenic point of view there may be only 20 occlusal
surfaces but there are exactly 60-proximal surfaces in contact and
64-facial and lingual surfaces which are susceptible to decay.
occlusal surfaces are susceptible to decay due to faulty fissures
and grooves whereas proximal surfaces are more prone to decay
as a result of faulty relationships between the contact
areas,marginal ridges,embrassures and gingiva.

3. Proximal contact area
Definition: (According to Sturdevant’sSturdevant’s)
The area of proximal height of contour of the mesial or distal
surface of a tooth that touches (contacts) its adjacent tooth
in the same arch.

3

4. When teeth erupt to make proximal contact with previously
erupted teeth, there is initially a contact point. The contact
point becomes an area because of wear of one proximal
surface against another during physiologic tooth movement.
4

5. Function of contact area
 Prevent food impaction interdentally.
 Stabilize the teeth and maintain the integrity of arch.
 Provide adequate gingival embrasure space for normal
healthy interdental papillae and supporting alveolar bone.
 Improper contact area leads to food impaction between teeth,
causing
 periodontal diseases,
 secondary caries and
 possible tooth movement
5

6. •Contact areas must be observed from two aspects to obtain the proper
perspective for locating them:
- The labial or buccal aspect
- The incisal or occlusal aspect
The LABIAL OR BUCCAL VIEW will demonstrate the
relative positions of the contact areas cervico-incisally or
cervico-occlusally
.
6

7. 7
The INCISAL OR OCCLUSAL
VIEW will show the relative
position of the contact areas
labiolingually or buccolingually.
In this instance, the center of the
area may be located in its relation
to the labiolingual or buccolingual
measurement of the crown.

8. CONTOUR

DefinitionDefinition:- :-
It is the term used to denote some degree of
convexities and concavities on the facial/buccal and
lingual surfaces of all the teeth that affords protection
to the supporting tissues during mastication
(STURDEVANT’S).(STURDEVANT’S).
8

9. Proximal contour of teeth

Area with maximum convexity on the
proximal surface –
9

10. Embrasures (spillways)
•Definition :- When two teeth in the same arch are in
contact, their curvatures adjacent to the contact areas
form spillway spaces called embrasures
(Wheeler’s)(Wheeler’s)
•According to According to Sturdevant’sSturdevant’s: : Embrasures are V-shaped
spaces that originate at the proximal contact areas
between adjacent teeth and are named for the direction
toward which they radiate. These embrasures are:
(1) Facial or buccal,
(2) lingual,
(3) incisal or occlusal, and
(4) gingival 10

11. 11

12. FUNCTION OF EMBRASURES:-
They form spillways between teeth to direct food away from the
gingiva.
They provide a mechanism for teeth to be more self cleansing.
 Lastly, they protect the gingiva from undue frictional trauma but
also providing the proper degree of stimulation to the tissues.
12

13. 13

14. Relation of contact area, embrasures & interdental col
14
• In the posterior teeth the papilla may be shaped like a mountain range,
with facial and lingual peaks and the col ("valley") lying beneath the
contact area.
•This col, a central-facio-lingual concave area beneath the contact, is
more vulnerable to periodontal disease from incorrect contact and
embrasure form because it is
covered by :
NON-KERATINIZED EPITHELIUM.

15. F
ACIAL & LINGUAL CONTOURS
In a vertical direction, all tooth crowns will exhibit
some convex curvatures occlusal to cervical line.
This curvature is some times called the cervical
ridge. In any mouth the average curvature is 0.5 mm
or less.
In mandibular posterior teeth the lingual curvature is
about 1 mm, with crest of curvature at the middle
third of the crown instead of the cervical third., due
to the lingual inclination of these teeth.

16. MARGINAL RIDGE
Marginal ridges are those rounded
borders of the enamel that forms the
mesial and distal margins of the occlusal
surfaces of premolars and molars and
the mesial and distal margins of the
lingual surfaces of the incisors and
canines.(wheeler’s)

A marginal ridge should always be
formed in two planes bucco- lingually,
meeting at a very obtuse angle.
This feature is essential when an
opposing functional cusp occludes with
the marginal ridge.

17. Imperfect formation, destruction or improper restoration of the contact
areas,contour,MR

Food Impaction
Inflammation of superficial Proximal Caries
Tissues
Acute or chronic

Vasomotor nerves of the deeper
Periodontal structures are first
stimulated, then overstimulated
and finally depressed in activity

Infection of soft tissues and adjacent bone
Tooth loss
 

18. INTRAORAL PREPARATION
Procedures for formulation of proper contacts and
contours two operative acts must precede or accompany
the restorative procedure:-
Tooth movement
Matricing

19. TOOTH MOVEMENT
It is the act of either separating
the involved teeth from each
other, bringing them closer to
each other,and/or changing their
spatial position in one or more
dimensions

20. OBJECTIVES :-
1) To bring the drifted, tilted, rotated teeth to their indicated
physiologic position for proper production of proximal surfaces.
2) To close the space between the teeth not amenable to closure by
restoration.
3) To move the tooth to another location so that when restored they
will be in a position physiologically acceptable by the periodontium.
4) To extrude or intrude the tooth in order to make them restorable.
5) To move the tooth from traumatic or non functional position to a
physiologic position.
6) To move the teeth so that when restored they will be in most
esthetic position.
7) To move teeth in a direction and to a location to increase the
dimensions of available tooth structure for the resistance and retention
forms of the contemplated restoration.
8) To create a space sufficient for the thickness of the matrix band
interproximally.

21. 21
RAPID/IMMEDIATE TOOTH
MOVEMENT
SLOW/DELAYED
TOOTH MOVEMENT
WEDGE PRINCIPLE TRACTION PRINCIPLE
SEPARATING
WIRES
OVERSIZED
TEMPORARIES
ORTHODONTIC
APPLIANCES
ELLIOTS
SEPARATOR.
WOODEN OR
PLASTIC
WEDGES
NON INTERFERING TRUE
SEPARATOR.
FERRIERS DOUBLE BOW
SEPARATOR.
IVORY ADJUSTABLE
SEPARATOR.
PERRY SEPARATOR.
PARR’S UNIVERSAL
SEPARATOR.
FOR
INSTANTENOUS
SEPARATION
RUBBER DAM
SHEET
SEPARATING
RUBBER BAND

22. RAPID OR IMMEDIATE TOOTH MOVEMENT

Mechanical type of separation that creates either
proximal separation at the point of the separator’s
introduction or improved closeness of the proximal
surface opposite the point of separator’s introduction.
Should not exceed the thickness of the involved tooth
periodontal ligament, as more seperation can tear
these ligaments at one site and crush them at other.
Should not exceed 0.2 – 0.5 mm.
Folllowing are the methods :-
1)Wedge method.
2)Traction method.

23. I) WEDGE METHOD :-
Separation is accomplish by insertion of a
pointed wedge shaped device between the
teeth, in order to create separation at a
point or closure on opposite proximal side.
a)Elliot separators :-
It is indicated for short duration separation
that does not provide stabilization.
PROCEDURE :-
Adjust the two opposing wedges of the
separator interproximally so that they are
positioned gingival to the contact area
without impinging gingiva or rubber dam
sheet.
Move the knob clockwise so that wedges
move towards each other and provide
seperation.

24. b) WOOD OR PLASTIC WEDGES :-
 Triangular or round shaped wedges,
usually made of medicated
wood(pine/oak) or synthetic resin.
In cross section the base of triangular
wedge will be in contact with the
interdental papillae, gingival to the
gingival margin of the proximal
cavity.
The two side of the triangle should
co-incide with the corresponding two
sides (mesial & distal) of the gingival
embrasure.
The apex of the triangle should
coincide with the gingival start of the
contact area.

25. 25
• Round: can be made from
wooden toothpicks.
•used in ideal class-II cavity
preparations

•Triangular : cavities with deep
gingival margins

26. The main advantage of wood wedges are that they
are easily cut and trimmed and they absorb water
intraorally. This causes them to swell, improving
their interproximal retention .The main advantage
of resin wedges is that they can be plastically
molded.
FUNCTIONS OF WEDGES :-
I)Close adaptation of matrix band with tooth.
II)Create some separation to compensate for the
thickness of matrix band.
III)Establish retraction of rubber dam and the gingiva
from the gingival margin of the cavity preparation.
IV)Assure immobilization of matrix band.
V)Prevent over hanging of the restoration.

27. ABC WEDGE
Absolute Best Contact
No more crushed matrix bands- the ABC
wedges are inserted from buccal and
lingual, the wings support the matrix band
and seal the gingival floor.
The simple design is easily modified for
the perfect fit.
Kit includes
Retainer spring forceps
 
 Two outward mega rings
 
right and left wedges in L, M, S, and XS
size

28. WEDGING TECHNIQUES
1)PIGGY BACK WEDGING :-
When there is gingival
recession and proximal box is
shallow gingivally,a single
wedge may be very much
apical to the gingival margin.
In such cases a second usually
smaller wedge is “piggy
backed” over the first.This will
ensure proper contour of the
matrix band.

29. 2) DOUBLE WEDGING :-
Indicated when the proximal box is
wide bucco lingually or when there is
spacing in between the teeth.
Two wedges one from buccal and one
from the lingual aspect to provide
close adaptation of matrix band.
3) WEDGE WEDGING :-
Employed primarily on mesial aspect
of maxillary first premolar.
Since these teeth have concave areas in
the root near the gingival margin,
placing a single wedge may lead to
open margin gingivally.
Therefore a second wedge is
introduced between first wedge and
band.

30. MATRICING
MATRIX (1871 DR.LOUIS JACK):-
Derive from latin word “MATER” which means “mother”
It is a device used during restorative procedures to hold the
plastic restorative material within the tooth while it is setting.
It is essential for proper reproduction of the proximal,facial
and lingual anatomy in any restoration of plastic nature.
It is the procedure whereby a temporary
wall
is created opposite to axial walls,
surrounding areas of the tooth structure
that
were lost during the cavity preparation.

31. IDEAL REQUIREMENTS OF A
MATRIX
Ease of application.
No hindrence with workablity of restoration.
Ease of removal
Rigidity
Provide proper proximal contact and contours
Non reactive
Inexpensive
Provide proximal pressure

32. OBJECTIVES
The matrix should :
•Displace the gingiva and rubber dam away from the cavity
margins during introduction of the restorative material.This
will assure maximum wetting and adaptation of the restorative
material to the prepared details.
•Assure dryness and non-contamination of details and space
covered-isolation
•Provide shape and contour to the restoration
•Maintain its shape during hardening of the restorative material
•Confine the restorative material within the cavity preparation
and pre-determined surface configuration.

33. PARTS OF MATRIX
1) BAND :-
This is a piece of metal or polymeric material
used to support and give form to the restorative
material during its insertion and hardening.
Materials used can be stainless steel, cellulose
acetate (cellophane), cellulose nitrate(celloid),
polyacetate(mylar).
Bands are available as strips of different
dimensions 0.001 to 0.002 inch thickness and
3/16
th
, 1/4
th
, 5/16
th
inch width.
2) RETAINER :-
This is a device by which the band can be
maintained in its position and shape.
Mechanical device,wire,dental floss,compound.

34. CLASSIFICATION OF MATRICES
I. DEPENDING ON THE TYPE OF MATERIAL USED :-
1) Stainless Steel
2) Copper Band
3) Cellulose Acetate (Cellophane)
4) Polyacetate (Mylar)
II. DEPENDING ON ITS PREPARATION :-
1) Custom Made Or Anatomic Matrix Eg:- compound supported
matrix.
2) Mechanical Matrix Eg:- Ivory No. 1 And 8, Tofflemire.
III. DEPENDING ON ITS MODE OF RETENTION :-
1) With Retainer Eg:- Tofflemire
2) Without Retainer Eg :-Auto Matrix.

35. IV. DEPENDING ON THE CAVITY PREPARATION FOR
WHICH IT IS USED :-
1) Class I cavity preparation with buccal or lingual extension:-
eg :-double banded tofflemire matrix.
2) Class II cavity :-
eg :-single banded tofflemire, ivory no. 1 and 8, compound
supported matrix,copper band matrix, T –band matrix, pre-
contoured sectional matrix and auto matrix.
3) Class III cavity :-
eg :-S- shaped matrix, cellophane strips, mylar strips.
4) Class IV cavity :-
eg :- cellophane strips, transparent celluloid crown
forms,dead soft metal strips.
5) Class V cavity :-
eg :-window matrix, tin foil matrix, preformed transparent
cervical matrix.

36. 36

37. 37

38. Matrices for Class I cavity preprations to receive a
restorative material inserted in a plastic state
(Double-banded Tofflemire)
In class I cavities matrices
are not usually required
unless we have to restore a
cavity with buccal or
lingual extensions.
38

39. Single-banded Tofflemire for
Class II designs
This is also referred to as the
UNIVERSAL MATRIX.
 It was designed by B.R. Tofflemire.
 The matrix is usually preferred for
most class II amalgam restorations.
39
Matrices for Class II cavity preprations to receive a
restorative material inserted in a plastic state

40. Parts
Head
Small knurled nut
Large knurled nut
Locking vise
Pointed spindle
40

41. Two types:
1.Straight tofflemire retainer
Here the head is straight.
 This retainer can be positioned only
from the buccal side.
2.Contra angled tofflemire retainer:
In this the head is angled so that the
retainer can be placed either from the
buccal or the lingual side.
TOFFLEMIRE AVAILABLE IN 2 SIZES
1.   Standard – for use in the adult
dentition
2.   Small – for use in the primary
dentition 
 
41

42. INDICATIONS
For class I cavities with buccal or lingual extension
For restoring class II cavities on one or both proximal surfaces of a
posterior tooth
42
ADVANTAGES
•Ease of use
•Produces good contact and contour for most amalgam restoration
•Rigid and stable
DISADVANTAGES
1. Does not provide optimum contact & contour for posterior
composite restoration.
2.
  Not useful for extensive class II
restoration.

43. IVORY NO. 1
This matrix consists of a stainless steel band which encircles
one proximal surface of the tooth.
This is attached to retainer via a wedge shaped projection.
As the adjusting screw is rotated clockwise the wedge shaped
projections engage the tooth at the embrasures of the
unprepared proximal surface.
INDICATIONS:-
For restoring a unilateral class II cavity especially
when the contact on the unprepared side is very tight
43

44. IVORY NO. 8
•This matrix consists of a band that encircles the entire
crown of the tooth.
•The circumference of the band can be adjusted by the
adjusting screw present in the retainer.

INDICATIONS
•For restoring class II cavities on one or both proximal
surfaces of a posterior tooth.
Disadvantages of Ivory no. 1 & Ivory no. 8
1.Remnants of old technique and are not in common
use.
2.Cumbersome to place and remove.
44

45. BLACKS MATRICES
Blacks matrix with a gingival
Extension
To cover the gingival margin
of a subgingival cavity.
45
Plain band
• For simple cases
• Small & medium size
cavities

46. T- SHAPED MATRIX BAND
Preformed brass, copper or stainless
steel bands are used with the long arm
of the “T” surrounding the tooth and
overlapping the short arm.
METHOD :-
The long arm of the ‘T’ is bent or curled
to surround the tooth circumferentially
and to overlap the horizontal arm of
the ‘T’ this section is then bent over the
long arm and thus helps to retain the
shape.
The band is adjusted according to the
circumference of the tooth, stabilized
by wedging and supported with low
fusing compound
46

47. INDICATIONS :-
1) For class II cavities involving one or both proximal
surfaces of a posterior tooth.
ADVANTAGES :-
1)Simple and inexpensive matrix system.
2)Rapid and easy to apply.
DISADVANTAGES :-
1) Not very stable.

48. MATRICES FOR CLASS III DIRECT TOOTH
COLOURED RESTORATIONS
usually transparent plastic matrix strips
are used.
plastic matrix strips made of celluloid are
used for silicate cements and
cellophane strips are used for resins.
mylar strips may be used for composites
and silicate cement restorations.
48

49. A. Matrix for class III preprations with teeth
in normal alignment
Band strip matrix
B. MATRIX FOR TWO SMALL PROXIMAL
PREPRATIONS IN CONTACT WITH EACH OTHER
T shaped band for cases having two class III cavities on
adjacent teeth
49

50. MATRICES FOR CLASS IV PREPRATIONS FOR
DIRECT TOOTH-COLORED MATERIALS

A. PLASTIC STRIP

it is used for inciso proximal
cavities.
50
B. ALUMINIUM FOIL INCISAL
CORNER MATRIX:
• These are stock metallic matrices shaped
according to the proximo incisal corner and
surfaces of anterior teeth.
• They cannot be used for resin based
restorative material.

51. MATRICES FOR CLASS V AMALGAM RESTORATIONS

These are usually not indicated except for
restoring those cavities which are very wide
occluso-gingivally and/or mesiodistally.
a. WINDOW MATRIX:
it is formed using either a Tofflemire matrix
or a copper band matrix.
b. THE S-SHAPED MATRIX
indicated on proximal extension of a buccal or lingual
class – V preparation.
c. Other options in lieu of matrices in extremely wide Class V cavities.
cavity prepared in two stages: mesial half prepared and filled with
amalgam.
: distal half is prepared and restored
51

52. MATRICES FOR CLASS V PREPRATIONS FOR
DIRECT TOOTH COLOURED RESTORATIONS
52
A.Anatomic matrix for non- light cured, direct
tooth colored material

B.Aluminum or copper collars for non light
cured direct tooth colored restorations

Aluminium or copper bands are preshaped
according to gingival third of the buccal and
lingual surfaces.

53. BiTine Rings
The BiTine Rings create a gentle tension that gently
presses a treatment tooth away from its abutment
contact, eliminating the need for forced wedging.
The sectional matrices are contoured precisely to
recreate the natural morphology between teeth, and
they come in 3 sizes.
53