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Fig 3: Caries end point removal, Fig 4: The first band (FXH175) was placed in the Fig 5: Next, an identical band was inserted into the
achieving peripheral seal zone and distal defect of tooth #45 and secured using a mesial defect of tooth #46 by slightly repositioning
removing unsupported enamel. The Large Quad Wedge. the wedge, allowing the band to pass beneath it.
picture was taken after air abrasion The wedge was then reinserted to its full length,
and selective etching was performed. holding the bands in place with gentle finger
Garrison® Quad Matrix System™ large pressure, ensuring both bands were securely
wedge was placed as pre-wedging to positioned beneath the wedge. The wedge was
protect the rubber dam. partially removed, allowing for the molar band to
be inserted more deeply using finger pressure.

Fig 6: Both bands are secured with Quad large Fig 7: Next, a Quad Universal Ring (blue) was Fig 8: After removal of the ring and band
wedge ensuring tight seal. placed between teeth #45 and #46. The ring’s (conversion of the Class II to Class I).
unique design works with the Quad wedge
to create a tight seal, control excess material,
and form a natural contact between the teeth.
This combination also allows for efficient
restoration of adjacent teeth.

connecting the occlusal and interproximal areas during first-time restoration initially seemed to be the most suitable option. However,
interproximal caries restoration (see Figure 3). The proximal walls after discussing treatment choices with the patient, we decided to
were finished using Shofu Super-Snap disks, starting with the violet proceed with a fiber-reinforced composite restoration using Ribbond
disk, followed by green and pink disks. This approach ensures optimal fibers.
enamel bonding and helps prevent potential microleakage. Selecting the appropriate sectional matrix system is crucial in
Air particle abrasion was performed using 25-micron aluminum cases involving adjacent large defects. We opted for the Garrison®
oxide powder. This process cleaned the cavity preparation and Quad Sectional Matrix™ system. Ensuring that the marginal ridge is
enhanced bonding strength, particularly by increasing microporosity correctly dimensioned and aligned with the occlusal anatomy is vital
in the root dentin. for creating well-defined adjacent triangular fossae and a properly
Given the extensive defects, particularly in tooth #44, indirect shaped occlusal embrasure. The height of the marginal ridge largely

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Dental Practice I January-February 2025 I Vol 21 No 1 37