Innovative orthodontic band matrices in pediatric dentistry for Class II restorations.

Although they are not a finding in contemporary pediatric dentistry textbooks or other literature, the utilization of orthodontic bands for Class II fillings in pediatric dentistry because of good gingival fit and interproximal contours can be very useful. In the deciduous dentition for the first primary molar, a lower first bicuspid band is recommended. For the second deciduous molar, an upper bicuspid band or lower second bicuspid band can be utilized. For Class II restorations in permanent teeth clinicians are encouraged to use the appropriate permanent band for the tooth being restored. The technique requires that the band is reduced gingivally and occlusally on the interproximal side of the tooth that is not cariously involved to allow deeper seating on the inter-proximal side with caries involvement (Fig 1). If the caries extends deep gingivally in the interproximal area, the orthodontic band can be elongated by the addition of a custom-made stainless steel “apron” welded to the orthodontic band made out of .003x.125 or .003x.150 permachrome band material (Fig 2). In using the orthodontic band, optional holes can be cut on the lingual and succal labial surfaces to allow for transenamel polymerization of light cured materials (Fig 3). It has not been the author’s experience that this is necessary but the interior of the band can be painted with a separating medium to facilitate removal of the band with no adhesion of the filling material. In adapting the band as a matrix, it is most important that the fit be very secure and snug at the gingival seat of the preparation’s interproximal box. The buccal and lingual proximal sides of the box can have some flair, which with appropriate cavity preparation is easy to manipulate for the removal of the “flash”. To insure an excellent tight contact the following should be performed: