Distal of the upper second molar. As it’s hard to clean makes it a classic place for decay. Competing for space with the coronoid process and the buccal pad makes restoration especially difficult. Yet the most challenging thing I found was adapting a well sealed, contoured matrix.
The challange

Without an adjacent tooth you cannot place a sectional matrix. Left then with a tofflemire or similar we tend to form cone shaped straight walls. Yet worse still we often have an open gingival margin because wedging isn’t possible.
Unsealed margins mean overhangs, Bonding contamination and poor long term outcomes. Not ideal when you’re striving to give patients the best outcome.
The Cricket Matrix.
Saddle matrix Kit from Orien Dental Set up In place – in seconds
Also known as a saddle matrix, the cricket matrix solves these issues. Sold in Australia by orien dental, these little bands of goodness really make your life easier when they’re required.
Pre-op. Distal caries/fracture Prep Matrix on (had to adjust clamp) Composite placed – terrible anatomy Final – Take photos, it opens your eyes to your mistakes and bad photography!
As well as solving the gingival adaption problem they are one of the quickest matrices to place and turn a slow difficult process into an easy restoration.
Dr Sahil Soni shared the advice at a young dentist conference and a tip like this made the whole cpd day worth it.
Caution!
If you use these be careful not to pack composite with too much force distally or you’ll end up with an overhang. Use heated composite or the ‘snow plough’ technique with flowable to easily avoid this. (And if necessary, a disk on reverse to fix it!)
Give it a shot and let the group know how it went. If you found this helpful please share it with colleagues and like or follow on Facebook and Instagram!