After successful completion of this module, you will be familiar with: Indications for using a sedative filling Placem

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8. 8 Examine the cavity preparation and memorize the shape of the preparation. Assemble the Tofflemire matrix holder. Place the matrix band around the tooth. The matrix band is sharp, so use caution when placing to avoid injury The Tofflemire matrix holder should be parallel to the facial surfaces of the teeth. Push the band through the proximal surfaces with your thumb Carefully push the band toward the gingiva until the band is below the gingival margin of the cavity preparation Tighten the matrix band around the tooth, it should fit the tooth tightly Place the wedge on the opposite side as the holder with the cotton pliers Check the matrix band and wedge. You should not be able to place an explorer tip between the band and the gingival wall of the cavity preparation.Examine the cavity preparation and memorize the shape of the preparation. Assemble the Tofflemire matrix holder. Place the matrix band around the tooth. The matrix band is sharp, so use caution when placing to avoid injury The Tofflemire matrix holder should be parallel to the facial surfaces of the teeth. Push the band through the proximal surfaces with your thumb Carefully push the band toward the gingiva until the band is below the gingival margin of the cavity preparation Tighten the matrix band around the tooth, it should fit the tooth tightly Place the wedge on the opposite side as the holder with the cotton pliers Check the matrix band and wedge. You should not be able to place an explorer tip between the band and the gingival wall of the cavity preparation.

9. 9 Mix the IRM to the correct consistency and roll into a small ball. Using the plastic filling instrument, place the IRM, in small increments, into the preparation. Place the material into the deepest part of the preparation first. Continue to place the nib end of the instrument into IRM and gently condense the IRM against the bottom of the preparation Place the material into all areas of the cavity preparation Keep placing small increments of IRM into the cavity preparation until it is slightly overfilled. Mix the IRM to the correct consistency and roll into a small ball. Using the plastic filling instrument, place the IRM, in small increments, into the preparation. Place the material into the deepest part of the preparation first. Continue to place the nib end of the instrument into IRM and gently condense the IRM against the bottom of the preparation Place the material into all areas of the cavity preparation Keep placing small increments of IRM into the cavity preparation until it is slightly overfilled.

10. 10 Starting at the tooth structure next to the buccal margin of the restoration, move the explorer toward the lingual surface of the tooth to contour the marginal ridge. Repeat the movement until the proximal surface of the marginal ridge is contoured Contour the occlusal surface Next, place the end of the plastic filling instrument in the center of the occlusal surface Pull the plastic filling instrument toward the buccal and lingual margins to form a central groove Use the nib of the plastic filling instrument to indent the IRM to form the mesial and distal fossa of the restoration Carve the occlusal surface Allow the IRM to almost set before carving the occlusal surface. The IRM is ready for carving when it is stiffer than dough, but not hard. Put the tip of the cleoid discoid carver in the central groove of the restoration. Lay the cutting edge on the margin of the restoration. The cutting edge should be half on the tooth surface and half on the restoration Move the instrument along the margins of the restoration and remove the extra sedative filling material. Repeat until the occlusal margins of the sedative filling are even with the tooth surface. Use the tooth anatomy to guide the instrument along the margins of the sedative filling Remove the Wedge and Matrix Band Use cotton pliers to remove the wedge Turn the inner knob of the Toffelmire matrix holder clockwise to loosen the band around the tooth and turn the outer knob counterclockwise Lift the Toffelmire matrix holder occlusally to remove it from the matrix band Place your thumb over the marginal ridge of the sedative filling and remove the band from the uncut proximal surface of the tooth Hold the ends of the matrix band a few millimeters away from the proximal surface of the restoration and move 1 - 2mm toward the buccal Slowly pull the band toward the occlusal until it is through the contact area Carve the Proximal Surface Place the Hollenback carver in the buccal interproximal space. The cutting edge of the instrument must rest against the tooth surface below the gingival margin Move the instrument up (i.e. toward the occlusal) along the margin of the restoration. The cutting edge of the instrument should be on both the enamel and the sedative filling. Repeat until the margin of the sedative filling is even with the tooth surface Repeat steps a and b to contour the lingual proximal surface of the sedative filling Use dental floss to check the proximal contactStarting at the tooth structure next to the buccal margin of the restoration, move the explorer toward the lingual surface of the tooth to contour the marginal ridge. Repeat the movement until the proximal surface of the marginal ridge is contoured Contour the occlusal surface Next, place the end of the plastic filling instrument in the center of the occlusal surface Pull the plastic filling instrument toward the buccal and lingual margins to form a central groove Use the nib of the plastic filling instrument to indent the IRM to form the mesial and distal fossa of the restoration Carve the occlusal surface Allow the IRM to almost set before carving the occlusal surface. The IRM is ready for carving when it is stiffer than dough, but not hard. Put the tip of the cleoid discoid carver in the central groove of the restoration. Lay the cutting edge on the margin of the restoration. The cutting edge should be half on the tooth surface and half on the restoration Move the instrument along the margins of the restoration and remove the extra sedative filling material. Repeat until the occlusal margins of the sedative filling are even with the tooth surface. Use the tooth anatomy to guide the instrument along the margins of the sedative filling Remove the Wedge and Matrix Band Use cotton pliers to remove the wedge Turn the inner knob of the Toffelmire matrix holder clockwise to loosen the band around the tooth and turn the outer knob counterclockwise Lift the Toffelmire matrix holder occlusally to remove it from the matrix band Place your thumb over the marginal ridge of the sedative filling and remove the band from the uncut proximal surface of the tooth Hold the ends of the matrix band a few millimeters away from the proximal surface of the restoration and move 1 - 2mm toward the buccal Slowly pull the band toward the occlusal until it is through the contact area Carve the Proximal Surface Place the Hollenback carver in the buccal interproximal space. The cutting edge of the instrument must rest against the tooth surface below the gingival margin Move the instrument up (i.e. toward the occlusal) along the margin of the restoration. The cutting edge of the instrument should be on both the enamel and the sedative filling. Repeat until the margin of the sedative filling is even with the tooth surface Repeat steps a and b to contour the lingual proximal surface of the sedative filling Use dental floss to check the proximal contact

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