Wedges in restorative dentistry: principles and applications

Abstract

Overhanging margins of proximal restorations are a well-known, iatrogenic cause of periodontal pathology. The high incidence of such findings in Western societies should arose the concern of the dental community. However, overhanging margins represent only part of the iatrogenic problem created by the misuse of wedges in restorative procedures. Other causes include incorrect proximal contouring, inadequate contact points and under- or overfilling the restorative material. The understanding of the variables associated with wedge selection and positioning has a major role to play in the prevention of iatrogenic periodontal pathology associated with restorative procedures. It is concluded that: (i) the occlusion of the matrix band to the remaining healthy tooth structure of the gingival cavosurface line angle should be achieved solely by the correct application of the wedges; (ii) the effect of the wedges on the proximal contour and contact area should be carefully re-evaluated prior to insertion of the restorative material; (iii) various sizes and shapes of wedges and a sharp knife for carving must be readily available.

The Influence of Matrix Type on the Proximal Contact in Class II Resin Composite Restorations

“…In the current study, all the matrices were secured with one wedge each and it was always inserted from the lingual side, because the lingual triangular embrasure was wider than the buccal one. 31 The single wedge was considered to offer adequate support and satisfactory adaptation of the matrix towards the restored tooth. The straight circumferential matrix lacks a contour but is more easily adjustable; whereas the pre-contoured matrices are believed to create more anatomically correct surfaces, 15 and the transparent matrix with reflective wedges might allow for better light transmission and allegedly more efficient polymerization of the underlying resin composite.…”

A randomized clinical trial on proximal contacts of posterior composites

“…A wooden wedge is pressed firmly in the interdental space before cavity preparation and kept in place during preparation. [3][4][5] Another study shows that a special separation ring combined with a sectional matrix resulted in tight proximal contacts in vitro. 2 However, no clinical research is available to prove the effectiveness of both these techniques in the amount of obtained interdental separation.…”

Creating Tight Proximal Contacts for MOD Resin Composite Restorations

“…Hence, when matrices are applied simultaneously to both proximal boxes prior to restoration, bleeding from the papilla will not be able to access the cavity. 25 A noteworthy aspect is the decision by the authors not to use amalgam as a test material. Amalgam was shown to produce tighter proximal contacts compared to resin composite.…”