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Department of conservative
dentistry and Endodontics

Under guidence of-

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Submittetd by- Anil kumar
 CONTENTS

• Introduction
• Contacts
• Contours
• Proximal Contact Area
• Embrasures
• Marginal Ridges
• Procedures for formulation of proper contacts and contours:
• Toothmovement
• Rapid
• Slow
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 • Matricing
• Classification
• Types

• Conclusion
• References

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• Presence of proper contacts & contour is important to maintain stability &
occlusal harmony.

• A thorough knowledge of the contacts & contours of various teeth is

mandatory for understanding:

• Predisposing factors of proximal caries like faulty interrelationships.

• Significance of marginal ridges, embrasures for re-establishing the

form and function of restored teeth.

• Periodontal aspect & health of the tooth to be restored.

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 • BENEFITS OF AN IDEAL
CONTACT & CONTOUR:

1. Conserves the health of peridontium

2. Prevents food impaction

3. Makes area self cleansable

4. Improves longevity of proximal restorations

5. Maintains normal mesiodistal relationship of the teeth in the dental
arch

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• ROLE OFA DENTIST IS TO ESTABLISH THE IDEAL EXTENSION SO AS
TO PERFORM OPTIMAL FUNCTIONS, MAINTAINING THE INTEGRITY
AND LONGEVITY OF INDIVIDUAL TOOTH.

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Food we consume moves in 3 different
directions:

• Occlusal surfaces

• Contact & Gingival embrasures

• Facial & Lingual sulcus

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• Any decay occurring on the proximal surface is
mainly due to faulty interrelationship between
• Contact Areas
• Marginal Ridges
• Embrasures
• Gingiva.

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• TIME OF ERUPTION: ONLY
CONTACT POINT ARE PRESENT

• Proximal Contact Point Proximal Contact Area

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 PROXIMAL CONTACT AREA

• Area of proximal height of contour of the mesial or distal surface of a

tooth that touches the adjacent tooth in the same arch.

• According to their general shape, 3 types:

1. Tapering teeth : Wide crowns & narrow cervical region

2. Square type : Bulky, angular with little rounded contour
3. Ovoid type : A transitional type between tapering & square types
: Surfaces are convex but infrequently they may be
concave 11
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CONTOURS
• Convexities on the facial & Lingual surfaces of tooth
that affords protection & stimulation of the supporting
tissues during mastication.

Functions of contour:

1. Deflecting food away from gingival margin

2. Maintenance of periodontal tissues
3. Maintain contact with adjacent tooth

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 HEIGHT OF CONTOUR
• Area of greatest circumference on the facial and lingual surface of the
teeth.

• Protects the gingival tissue by preventing food impaction.

ANTERIOR POSTERIOR

Cervical 3rd on facial Gingival 3rd on facial

& lingual surface surface
Middle 3rd on lingual
surface

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 TYPES OF CONTOUR
OVERCONTOUR
• Deflects food away from gingiva
• Understimulation of supporting tissues
• Plaque accumulation

UNDERCONTOUR

• Irritation to soft tissues

ADEQUATE CONTOUR

• Stimulation of supporting tissues

• Healthy peridontium 14
 EMBRASURES
(SPILLWAYS)
• V-shaped spaces between the teeth that
originate at the proximal contact areas
between adjacent teeth.

• Curvature formed by two adjacent teeth in an

arch form a spillway space that is called an
embrasure.

• Serves 2 purposes:
• Provides a spillway for passage for food during mastication
• Prevents food from being forced into the contact area 15
• Named for the direction towards which they radicate:
facial, lingual, incisal/occlusal, gingival

Facial/Buccal
Incisal/Occlusal

Lingual/Palatal
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Gingival
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• Embrassure is reduced: Additional stress is created in teeth &
supporting structures.

• Embrassures is large: Less protection to supporting structures

• Lingual embrasure is greater than buccal, since tongue can

displace food occlusally.

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 MARGINAL RIDGES

• Rounded borders of enamel that forms the mesial

& distal margins of occlusal surfaces of molars &
premolars and the mesial and distal margins of
lingual surfaces of incisors and canine.

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• Functions:
• Helps in prevention of food impaction proximally
• Mastication
• Protection of peridontium

• Marginal ridges of adjacent posterior teeth should be at the same height to

have a proper contact and embrasure forms.

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• MARGINAL RIDGES WITH NORMAL OCCLUSAL

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• MARGINAL RIDGES WITH EXAGGERATED OCCLUSAL
EMBRASURES CAUSES DRIFTING OF TOOTH WHICH LEADS
TO WEDGING OF FOOD

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• ADJACENT MARGINAL RIDGES ARE NOT COMPATIBLE IN
HEIGHT - DRIVES THE DEBRIS INTERPROXIMALLY.

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• MARGINAL RIDGES WITH NO TRIANGULAR FOSSA, THE
VERTICAL FORCES WILL IMPACT FOOD INTERPROXIMALLY.

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• THIN MARGINAL RIDGES WILL BE SUSCEPTIBLE TO FRACTURE
OR DEFORMATION

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• MARGINAL RIDGES WITH NO OCCLUSAL EMBRASURES, THE 2
ADJACENT MARGINAL RIDGES WILL ACT LIKE A PAIR OF TWEEZERS
GRASPING THE FOOD SUBSTANCE PASSING OVER IT.

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PROCEDURES OF PROPER CONTACTS & CONTOURS

• Intraoral procedures:

• Tooth movement
• Matricing

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• Act of separating the involved teeth from each other, bringing them
closer to each other or changing their spatial position in one or more
dimensions.

TOOTH MOVEMENT
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 TOOTH
MOVEMENT

Rapid / Immediate Slow / Delayed

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 RAPID/ IMMEDIATE MOVEMENT

• Mechanical type of separation

• Creates either proximal separation at the point of separator’s introduction

and/or improved closeness of proximal surface of opposite side.

• Separation shouldn’t exceed the thickness of the involved tooth’s

periodontal ligament thickness. ie: 0.2 – 0.5 mm

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 METHODS
1. Wedge method

• By insertion of a pointed wedge shaped device between the teeth

• The more the wedge moves facially or lingualy, greater is the separation.

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Elliots separator

• Indicated for short duration separation that does not necessitate

stabilization

• Useful in examining proximal surfaces in final polishing of restored

contacts.

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 Wood/ Plastic Wedges

• Used in both tooth separation for preparation and restoration

• Triangular shaped wedges (wood/synthetic resin)

• Cross-section base of triangle will be in contact

with interdental papillae.

• Apex must coincide with the gingival start of the

contact area. 32
• Types:
• Wooden
• Plastic
• Elastic
• Transparent
• Medicated wedges

• Shape:
• Triangular
• Round
• Trapezoidal
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 Wedging techniques

1. Single wedge technique

• Single wedge is placed in the gingival

embrasure

2. Piggyback wedging

• A second wedge is placed on top of the first

wedge to wedge adequately the matrix against
the margin

• Indicated for patients whose interproximal 34

tissue level has receded.
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3. Double wedging technique

• Here, 2 wedges, one from the facial embrasure and the other from the
lingual embrasure are used.

• Used when proximal box is wide faciolingually.

• Should be used only if the middle 2/3rd of the

proximal margins can be adequately wedged.

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4. Wedge wedging technique

• Used in cases when there is a gingival concavity as in the case of a

fluted root.

• Inorder to wedge a matrix band tightly against such a margin, a second

wedge is inserted between the first wedge and the band.

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Error’s with wedge placement

• If wedge is placed more occlusal to the gingival

margin, creates abnormal concavity in the proximal
surface of the restoration.

• If wedge is for apical to gingival margin, band will not

be held tightly against the gingival margin & creates
gingival overhangs in the restorations.

• Tightness of the wedge is tested by pressing the tip of an explorer firmly

several points along the middle 2/3rd of the gingival margin against the
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matrix band.
• Tightness of the wedge is tested by pressing the tip of an explorer firmly
several points along the middle 2/3rd of the gingival margin against the
matrix band.

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 2. TRACTION METHOD
• Done with mechanical devices which engage the proximal
surfaces of the teeth to be separated by means of holding
arms.

• Non-Interfering true separator

• Ferrier double-bow separator

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Non-Interfering true separator

• Indicated when continuous stabilized separation is required.

• Advantage:
• Separation can be increased or decreased after stabilization
• Device is non-interfering

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Ferrier double-bow separator

• Separation is stabilized throughout the dental operation.

• Advantage :
• Separation is shared by the contacting teeth and not at the
expense of one tooth

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SLOW/ DELAYED TOOTH MOVEMENT

Indications:

• When teeth have drifted and/or tilted considerably, rapid movement of

the teeth to proper position will endanger the periodontal ligaments.

Methods:
• Separating wires
• Oversized temporaries
• Orthodontic appliances
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 MATRICING

Procedure where a temporary wall is created opposite to the axial

walls,surrounding areas of tooth structure that were lost during
preparation.

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The matrix should:

• Displace the gingiva and rubber dam away from the cavity margins

• Assure dryness and non-contamination of the cavity

• Provide shape for the restoration during setting of the restorative
material
• Maintain its shape during hardening of the material

• Confine the restorative material within the cavity

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 CLASSIFICATION OF MATRICES:

1. Based on mode of retention:

i. With retainer (Tofflemire matrix)
ii. Without retainer (Automatrix)

2. Based on type of band

i. Metallic non transparent
ii. Nonmetallic transparent

3. Based on type of cavity for which it is used

i. Class I cavity
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a. Double banded Tofflemire (barton’s matrix)
ii. Class II cavity iv. Class IV cavity
a. Single banded Tofflemire a. Mylar strip
b. Ivory matrix No. 1 b. Transparent crown form
c. Ivory matrix No. 8 matrix
d. Copper band matrix c. Modified S-shaped

e. Automatrix
v. Class V
iii. Class III cavity a. Window matrix

a. Mylar strip b. Cervical matrix

b. S-shaped

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 UNIVERSAL MATRIX (TOFFLEMIRE MATRIX)

• Designed by BR. Tofflemire

• Ideally indicated when 3 surface posterior

tooth are prepared(i.e. mesial, occlusal,
distal)

• Commonly used for class II restorations

• 2 types:
• Straight
• Contra-angled
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 MATRIX BANDS:

1. Uncontoured bands
• Available in 2 thickness : 0.05 mm & 0.038 mm

• Burnishing the thinner band to contour is more difficult and less

likely to retain contours

2. Precontoured bands
• Needs little or no adjustment
• Expensive
• Difference in cost justified by lesser chair time. 49
 IVORY MATRIX NO.1
• Band encircles the posterior proximal surfaces so it is indicated in
unilateral class II cavities.

• Band is attached to the retainer via a wedge shaped projection.

• Adjusting screw at the end of the retainer adapts the

band to the proximal contour of the prepared tooth.

• As adjusting screw is rotated clockwise, the wedge

shaped projections engage tooth at the embrasures of the
unprepared proximal surface. 50

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 IVORY MATRIX NO. 8
• Consists of band that encircles the entire crown of the
tooth.

• Indicated for bilateral class II cavities.

• Circumference of the band can be adjusted by adjusting

the screw present in the retainer.

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 BLACK’S MATRICES
1. For simple cases recommended for majority of small & medium size
cavities
2. Blacks matrix with gingival extension

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 COPPER BAND MATRIX / SOLDERED BAND

• Indicated for badly broken down teeth such as those receiving pin retained
amalgam restorations & in complex class II restorations with buccal or
lingual extensions

• Cylindrical in shape

• Band with appropriate dimensions of crown are taken and the 2 ends are
soldered.

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• WITH CURVED SCISSORS, THE BAND IS FESTOONED IN THE CERVICAL
REGION TO FIT THE GINGIVAL CONTOUR OF THE TOOTH.

• Then with the contouring pliers, the band is contoured to reproduce the
proper shape of the contact areas.

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 ANATOMICAL MATRIX

• Most efficient means of reproducing contacts & contours

• Hand-made and contoured especially for individual teeth.

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 ROLL IN BAND MATRIX ( AUTOMATRIX)

• Retainerless matrix system with 4 types of bands that are designed to fit all
teeth regardless of circumference and height.

• Types:
• 3/16” (4.8mm), 0.002” thickness
• 1/4” (6.35mm), 0.002” & 0.0015” thickness
• 5/16” (7.79mm), 0.002” thickness

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S-SHAPED MATRIX
BAND

• For class III, class II and with facial/lingual extensions of

class V

• Matrix band of 0.001” – 0.002” is used

• Mirror handle is used to produce the S-shape in the strip

• Strip is contoured in its middle part with contouring pliers

to create desired form for the restoration

• Compound material is used to hold the band in position in

the facial and lingual aspect and also in the gingival aspect.
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 T-SHAPED MATRIX
• Premade T-shaped brass/ stainless steel matrix
bands

• Longer arms of the matrix is bent to encompass the

tooth circumferentially and to overlap the short
horizontal arm of ‘T’

• This section is then bent over the long arm, loosely holding it in place.

• Wedges can be used to stabilize the matrix.

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Indications:
• Class II cavities involving 1 or both proximal surfaces of a posterior
tooth

Advantages:
• Simple
• Inexpensive
• Rapid
• Easy to apply

Disadvantages:
• Flimsy in structure and not stable
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 MYLAR STRIPS
• For composite restorations in Class III and Class IV cavities.

Procedure

• Mylar strip is burnished with the end of an

instrument handle to produce a belly.

• This produces a normal contour of the

proximal surface of the teeth.
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• STRIP IS THEN CUT TO PLACE THE BELLY
WHERE THE CONTACT IS DESIRED.

• A wedge is trimmed and applied to hold the

strip in place.

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• Lingual aspect of strip is secured with index
finger

• Facial portion is reflected away for access.

• Following insertion of composite, matrix

strip is closed and material is cured through
strip.

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 TRANSPARENT CROWN FORM MATRIX
• Stock plastic crowns
• Can be used for light cured resin material
• For Class III and Class IV

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• INDICATIONS:
• Large bilateral/unilateral class IV cavity
• Oblique fractures of anterior teeth

• Advantages:
• Easy to use
• Good contours can be established

• Disadvantages:
• Time consuming
• Expensive
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 WINDOW MATRIX
• For class V cavities
• Formed using either a Tofflemire matrix or copper band.

Procedure:

• A window is cut slightly smaller than the

outline of the cavity.

• Wedges are placed, mesially & distally to

stabilize the band.
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 PREFORMED TRANSPARENT CERVICAL MATRIX
• For use with light cured resin material or RMGIC
• Matrix must be held in place while the restoration
is setting

• Indications:
• Class V restorations with composite or RMGIC

• Advantages:
• Provides good contour for restorations

• Disadvantages:
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• Expensive
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 CONCLUSION
• Proper restoration of the anatomical landmarks is important for
enhancing the longevity of restorations as well as to maintain the occlusal
health and harmony.

• Matricing is a vital step during the placement of different restorations.

• Selection of the matrix should be based on its ease of use and efficiency to
provide the optimum contacts and contours..

• The dentist should select the right method according to the needs of
individual case.
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REFERENCES

1. Operative Dentistry – MA Marzouk

2. Art & science of operative Dentistry – Sturdevants (5th edition)

3. Art & Science of Operative Dentistry – Sturdevants (South Asian Edition)

4. Textbook Of Operative Dentistry – Vimal K Sikri

5. Dental Anatomy, Physiology & Occlusion – Wheeler’s (9th Edition)

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