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V3 System: Frequently Asked Questions
Q. Do V3 Rings produce tight contacts?

 

A.

Yes. Experts agree that Triodent sectional matrix systems – using the V3 Ring or the V-Ring – are the surest way to achieve tight contacts since the lateral spring pressure acts like a McKean orthodontic tooth separator.¹A V3 Ring IS a sectional matrix. The only functional differences between the V-Ring system and other sectional matrices are:

  • The V3 Ring is particularly good at holding the matrix in a full anatomical curve.
  • The V3 Ring traps the matrix on the shoulders of the tooth and prevents it slipping and moving away from the neighboring contact point
  • The V3 Ring spring is made from nickel-titanium (NiTi) and is very resilient.
  • The V3 Ring spans wide cavities.
  • The retention is better.
  • The tooth separation is better as the lateral force of the spring is greater.

When you think about it, it can’t help but produce excellent contacts.

Dental Clinics of North America, Vol 45, # 1, Jan 2001, p87.

 

Q. Can V3 Rings be used on wide cavities?

 

A.

Yes. The anatomically-shaped tines grip on both adjacent teeth and this prevents the spring from falling into wide cavity preps (like other sectional matrices).

 

Dr Jason Smithson’s Wide Box Clinical Case demonstrates this.

 

Q. Can V3 Rings be used when a cusp is missing?

 

A.

Yes. Since the tines grip on both teeth on each side of the contact and also low down near the gingival margin, a V3 Ring can often be used when a cusp is missing. Depending on the anatomy, it is sometimes best to build up the bulk of the cusp before placing the V3 Ring.

 

Have a look at Missing Cusp Clinical Case by Dr Graeme Milicich.

 

Q. Can V3 Rings be used on primary teeth?

 

A.

Yes. The V3 Ring comes in two sizes – Universal (green) for molars and Narrow (yellow) for premolars and primary teeth.

 

Q. What degree of separation is achieved with the V3 Ring?

 

A.

The ring will create a separation of 60-80 microns. This is greater than the thickness of two Triodent matrices and is sufficient separation to restore two adjacent Class II cavities at the same time.

 

 

Q. Can V3 Rings be sterilized and re-used?

 

A.

Yes. They are designed for re-use and have been tested successfully through 800 autoclave cycles. The rings should be steam-autoclaved, maximum temperature 135°C. Other methods of sterilization run the risk of damaging or staining the rings. Chemical sterilization will void our warranty.

 

Q. How do I get bonding agent off the V3 Ring?

 

A.

The best course of action is to place the ring(s) in a beaker of warm water immediately after removing from the tooth.  After that you can proceed to scrub with a soft brush and/or plastic spatula to remove any debris (composite, bond) PRIOR to ultrasonic cleaning or autoclave. Once that material is baked on, it can be hard to remove. Any material should be removed immediately following ring removal with a flat plastic instrument and rings rinsed in water before autoclaving.
 
 

Q. How can the extra cost of V3 Rings be justified?

 

A.

V3 Rings are not much more expensive than other competing systems and they produce better results with less frustration and time spent. They are also made of NiTi and glass-fiber reinforced plastic, which lasts longer. The cost of the consumable V3 Tab-Matrix is similar to other sectional matrix bands. In addition, think how much it costs you every time you have to re-do a proximal restoration because it has a poor contact. If you try to re-do it right away you run late and get stressed out. If you do it later the patient “bad-mouths” you because they think you are incompetent. You lose credibility and waste more time with more costs and no income when you do have to re-do it! Arrrgh!

 

Q. Do V3 Rings work equally well on all teeth?

 

A.

The V3 Ring is a very versatile system and no other matrix system comes close in this respect.

 

Q. Do I have to hold the contact point with a burnisher while light curing? Could I use a regular matrix and hold the contact and then why would I need a V3 Ring?

 

A.

Dr McDonald always does this because it is so easy to do and avoids the bad contact caused by the matrix not being in contact with the neighboring tooth. Quite often it is impossible to see if the matrix is actually touching, so holding is just a precaution. Dr McDonald believes this issue is the single main cause of REALLY bad contacts. The V3 Ring’s function is to separate the teeth (orthodontically) and wrap the matrix.

A regular matrix (Tofflemire) when used on a Class II has the effect of moving the tooth in the wrong direction by the thickness of the matrix (because you have to get the matrix through the intact side). This means that you have to overcome TWO thicknesses of matrix to get a tight contact. Tofflemires also tend to produce cylindrical, “tin can”, restorations with a poor contour and a contact just at the marginal ridge. This method has been found to be unpredictable by most who have tried it.

 

Q. Which style of clamp should I use to hold the rubber dam in place?

 

A.

Often there is room for both the clamp and the V3 Ring. Our general advice is to use wingless clamps if space is going to be an issue. For example, on a #30 tooth, try a W3 or W7. Some brands of clamp leave more room than others. Don’t dismiss winged clamps entirely. If possible, place the clamp distal of the tooth being treated. Many dentists also use Wave-Wedges routinely to help keep the dam in place.

 

 

Q. Does the V3 Ring work if you are doing three teeth in a row i.e. #12DO, #13MOD, and #14MOL?

 

A.

Dr McDonald prefers to prep all at once, place the matrices on all teeth then place composite initial layers on all three teeth. Then he finishes layering 12 and 14 and pulls off the matrix on 12 and 14. Next he pushes the wedge in farther between 12-13 and 13-14, burnishes the contact on M and D of 13 and places the final layer on 13. Then he finishes all three at the same time.

 

Check out Dr Jason Smithson’s Quadrant Dentistry Clinical Case and Dr Gregori Kurtzman’s Contours for Direct Resin Restorations Clinical Case which shows an example of this.

 

Q. With the V3 Ring is it best to do them all separately start to finish or would you do 12 and 14 together and then 13 by itself?

 

A.

Yes you can do all four in a row if you want. You just need to make sure that the V3 Ring is separating the contact you are working on. You can move the V3 Ring along as you work, or stack rings. Dr McDonald prefers to use just one V3 Ring as it allows that embrasure to open rather than the retainer rings working against each other. Although he builds one contact at a time, he etches, bonds and places bands and/or matrices all at once.

 

Q. The V3 Ring is a small piece of equipment to put in the patient’s mouth. What if it springs out or is dropped?

 

A.

The V3 Ring is very stable on wet or dry teeth because of its strength and anatomically shaped faces. However, for added security tie floss to the ring.

 

Q. How do I retension the V3 Ring if the tines start to separate?

 

A.

We use NiTi in our rings. It has remarkable strength and elasticity, so the ring will return to its original shape again and again. The V3 Ring may separate slightly over time with over-stretching, but can be easily retensioned by placing it in the notches in the handles of the Triodent Forceps. Squeeze it like a nutcracker until the tines touch and the ring is as good as new. To prevent over-stretching, only open the ring as far as is needed to place it over the tooth. Also, try not to leave the ring open in the forceps for a long period of time.

 

Q. Can V3 Rings be used on MOD’s?

 

A.

V3 Rings work really well on single Class II restorations and MOD’s. You can stack the V3 Rings or have one facing mesially and the other distally. The ring tilts up, away from the marginal ridge of the tooth, allowing more room for another ring to be placed underneath, on the next tooth. In most cases it is advisable to place the rings in opposite directions.

 

See Contours for Direct resin Restorations by Dr Gregori Kurtzman.

 

Q. What’s the best way to restore a back-to-back MO or DO?

 

A.

The easiest method for back-to-back Class II restorations is to complete one and then do the other. Doing both simultaneously can be faster but requires more operator skill. A Narrow (yellow) V3 Ring is recommended as more separation is necessary to overcome two thicknesses of matrix.

 

Q. What is the best way to restore an MOD with the V3 Ring?

 

A.

The recommended method is as follows:

Pre-wedge both M and D and complete cavity preparation.

Slide M and D matrix into position and etch and bond.

Place V3 Ring on M and build and cure M contact point.

Move V3 Ring to D and build and cure D contact point.

Complete occlusal surface and cure with C-Factor issues in mind.

 

Q. What is the best way to remove the matrix band when it’s in a tight contact area and stuck to the composite?

 

A.

Push a thin, metal-blade instrument like a probe through the embrasure below the contact point to break the bond. Some clinicians also recommend flossing between the restoration and the band.

 

Q. Can I place the Wave-Wedge with the V3 Ring in place?

 

A.

Yes. The V-shaped tines of the V3 Ring allow you to place a wedge without removing the ring. And because the Wave-Wedge has a hollow underside, you can slide a second wedge from the opposite side to the first.

 

Q. When doing an MOD, the matrix band side extrusions are too long and get in the way of the opposing matrix band?

 

A.

The easy way around this is to place a V3 Ring on the first tooth, trapping the matrix band in place, then bend the protruding ends of the matrix backwards to make room for placement of another band on the opposite side of the restoration.

 

Review Dr Graeme Milicich’s Contact Points for further information.

 

Q. What are the differences between the V3 Ring and the V-Ring?

 

A.

The main differences are:

The V-Ring spring is made from nickel-titanium and stainless steel while the V3 Ring spring is made entirely from nickel-titanium. The spring is substantially stronger and, with the Narrow (yellow) ring, the range of action is wider with the V3. Because the V3 Ring does not have stainless steel, it will not expand over time to the extent of rings containing stainless steel.

The V3 Ring tines are made from glass-fiber reinforced plastic and are shaped to suit the buccal and lingual surfaces of the teeth, slightly more so than with the V-Ring.

The spring angle on the V3 Ring is steeper relative to the occlusal plane, making stacking easier for simultaneous multiple restorations.

The tines in the V3 Ring have special grooves that make them more stable in Triodent Forceps. They also fit rubber dam forceps, so there is no need to buy new instruments.

 

Q. Which style of rubber dam clamp should I use on, for example, a #30, that will not interfere with the V3 Ring?

 

A.

Firstly, it is usually better to use a wingless clamp, say a W3 or W7, but there are other options to consider, like an 8a or a serrated premolar clamp. Yet another thing to try is to use a normal clamp, rotated slightly, on the #31.

 

Q. Sometimes when I place the V3 Ring on the SuperCurve matrix, the ring and matrix slip up the tooth. How can I prevent that?

 

A.

This is most likely to occur on the buccal of lower molars and lingual of upper molars. If it happens, try placing the ring mesially instead of distally. Otherwise, wedge from both sides with Wave-Wedges or use the hard V-Wedge to secure the matrix. It’s a good idea to push down on the ring immediately after placement while it is still in the forceps to make sure the ring is fully seated on the undercuts, and keep your finger firmly against the matrix tab until you have released the forceps to ensure there is no slippage.

SuperCurve: Frequently Asked Questions
Q. Why does there sometimes appear to be less matrices in the pack then what is specified?

 

A.
Every SuperCurve matrix is made precisely and exactly. For that reason they are a perfect fit for each other and can nestle together, and it is possible you will take two without realizing it. To help prevent this, shake or tap the box before selecting a matrix.
Q. Sometimes when I place the V3 Ring on the SuperCurve matrix, the ring and matrix slip up the tooth. How can I prevent that?

 

A.
This is most likely to occur on the buccal of lower molars and lingual of upper molars. If it happens, try placing the ring mesially instead of distally. Otherwise, wedge from both sides with Wave-Wedges or use the hard V-Wedgeto secure the matrix. It’s a good idea to push down on the ring immediately after placement while it is still in the forceps to make sure the ring is fully seated on the undercuts, and keep your finger firmly against the matrix tab until you have released the forceps to ensure there is no slippage.
V3 Tab-Matrix: Frequently Asked Questions
Q. How do I use the tab on the V3 Tab-Matrix?

 

A.

Holding the matrix by the tab in Triodent Pin-Tweezers, simply bend the tab towards you (mesially) to create a “contra-angle” handle. Then move the V3 Tab-Matrix apically into the embrasure. Try to avoid trapping gingival tissue between the matrix and the gingival margin of the cavity.

 

Q. How do I prevent the little tab blocking my view of the cavity?

 

A.

While burnishing the V3 Tab-Matrix, bend the tab over and fold it out of the way.

 

Q. How do I remove the V3 Tab-Matrix if it appears to be stuck?

 

A.

Firstly, peel the matrix away from the composite as far as possible on both sides using a suitable instrument. Gently rocking the matrix back and forth should then make it easy to remove. Use Triodent Pin-Tweezers to grab the hole on the wings of the V3 Tab-Matrix and wiggle the matrix out. Grabbing the tab may rip it off but the lateral holes work better. You can also try flossing (waxed floss) between the matrix and the restoration. Take care not to lacerate the gingival papillae by excessively rocking the matrix.

 

Q. How do I keep the V3 Tab-Matrix in place while inserting a Wave-Wedge?

 

A.

If you prefer to place the V3 Tab-Matrix before the Wave-Wedge, use a finger to trap the matrix tab against the neighboring tooth while inserting the wedge. This will prevent the matrix sliding out of the embrasure.

Q. Can I place the V3 Tab-Matrix after placing the wedge?

 

A.

Yes. In fact this is usually the best way to do it. Place the Wave-Wedge first, BEFORE cavity prep. This pre-wedging prevents bleeding, separates the teeth slightly and positions the wedge more apically, thereby allowing the contact point to be lower. The wedge will also depress the interproximal gingivae and rubber dam and protect both from the high-speed bur. Most of the time you will then be able to slide the V3 Tab-Matrix into place without removing the wedge.

 

Q. How can I be sure that the composite has completely cured inside the V3 Tab-Matrix?

 

A.

To ensure complete curing of the composite, fold the wings of the V3 Tab-Matrix back (after removing the ring and wedges) and cure from the buccal and lingual sides.

 

Q. How do I get the greatest benefit out of the rolled marginal ridge on the V3 Tab-Matrix?

 

A.

Positioned correctly, the rolled marginal ridge on the V3 Tab-Matrix will save you a lot of time in finishing because it closely replicates the natural anatomy of the tooth. To maximize the benefits of the ridge, take care to position the band exactly. If it won’t go into the ideal position, slide the edge out while trapping the tab of the matrix against the neighboring tooth, then push the wedge back in. This method also eliminates the possibility of a gingival tag protruding into the cavity box.

 

Q. How can I stop hooking the tab of the V3 Tab-Matrix when I go to release the Pin-Tweezers?

 

A.

Triodent Pin-Tweezers have a gold tip on one side, which indicates the side with the pin. Insert the matrix with the gold tip facing away from the occlusal surface. Then when you release the tweezers, the pin will be well away from the tab.

 

Q. When doing an MOD, the matrix band side extrusions are too long and get in the way of the opposing matrix band.

 

A.

The easy way around this is to place the yellow V3 Ring on the tooth, trapping the matrix band in place, then bend the protruding ends of the matrix backwards to make room for the opposite matrix band.

Wave-Wedge: Frequently Asked Questions
Q. What can I do if there is a gap at the bottom of the axial corner of the box with the Wave-Wedge in place?

 

A.

The Wave-Wedge, because of its unique central concavity, has exceptional sealing capacity on the matrix at the gingival margin. However, if there is a gap, you can wedge from both sides, thanks to the hollow underside which allows you to stack the wedges.

 

Q. The point of the Wave-Wedge is quite sharp. Will it cut the gingival papillae?

 

A.

The Wave-Wedge’s banana-shape design and tapered tip ensures the wedge is self-guiding, gliding through the embrasure without catching on the papillae. Moreover, because of the hollow underside, the papillae is accommodated and protected during the restoration. That is why the Wave-Wedge is ideally placed BEFORE cavity prep. Lubricating the tip of the wedge with a water-based lubricant or LA paste will also help it slide through without catching the rubber dam.

 

Q. Apart from the adaptive sealing qualities, what are the reasons for the central concavity in the Wave-Wedge?

 

A.

The central concavity is actually the second feature in the Wave-Wedge’s remarkable bag of tricks. First come the fine lateral wings at the point of the wedge. These compress easily as the wedge enters the embrasure, and then expand again as the wedge exits on the other side of the tooth. This is when the concavity comes into its own, effectively locking the wedge into place at its central point, and wrapping around the matrix at the gingival margin for a broad, adaptive and symmetric seal. It is also then in the best spot for positioning the V3 Ring.

 

Q. What is the hole for in the end of the Wave-Wedge?

 

A.

While other wedges are easily dropped, Wave-Wedges and Triodent’s V-Wedges are secure in Triodent’s Pin-Tweezers which, as the name implies, have a pin in the end that goes into the hole. Because of the cross-over action of the Pin-Tweezers, the wedges will not fall out when the tweezers are held in a neutral position, and are very secure when the tweezers are gripped.

 

Q. Do Wave-Wedges separate the teeth?

 

A.

Unlike the Wave-Wedge and Triodent’s V-Wedge, most wedges have a conflict of function, needing to be hard enough to separate the teeth but soft and adaptive enough to provide a seal at the gingival margin. Triodent gives the job of separating the teeth to the V3 Ring or V-Ring, leaving the Wave-Wedge free in the role of holding the matrix and sealing the gingival margin.

WedgeGuard
Q. Can the WedgeGuard be used as a matrix band?

 

A.

No. The WedgeGuard is for protecting the adjacent tooth from unintentional damage. If you use it as a matrix it will create an overhang. After removing the metal shield, the wedge can then be used as a wedge, retaining all the qualities of a Triodent Wave-Wedge.

 

Q. The top of the WedgeGuard partially obscures my view of the cavity area and affects access. What can I do about that?

 

A.

You can improve vision and access by cutting away part of the guard, for example with a high-speed diamond bur.

 

Q. What if the contact is too tight to insert the WedgeGuard?

 

A.

If the contact point is too tight to get the WedgeGuard through, cut through the occlusal enamel into the carious lesion to weaken the marginal ridge. Once the marginal ridge is fractured off, it is easy to push the WedgeGuard through.

 

Q. How can I insert a matrix band with the wedge already in place when it is too tight?

 

A.

If there is no room to slide the matrix directly in between the wedge and the cavity, slide the wedge out partially, then place the matrix, then push the wedge back in. Use a finger to trap the matrix against the side of the tooth while doing this to ensure it does not move.

 

Q. Does the WedgeGuard separate the teeth?

 

A.

Most wedges have a conflict of function, needing to be hard enough to separate the teeth but soft and adaptive enough to provide a seal at the gingival margin. The WedgeGuard will separate the teeth just slightly but that is not its function. Triodent gives the main job of separation to the V3 Ring or V-Ring, leaving the WedgeGuard free to fulfill its role firstly as an interproximal guard and then to provide an excellent marginal seal when the guard is removed and replaced with a standard matrix.

 

Q. Can I stack other wedges under the WedgeGuard?

 

A.

Yes, you can. The wedge used in the WedgeGuard retains all the qualities of the Wa

V3 Blue: Frequently Asked Questions

The V3 Blue ring is clinically the same as the V3 nickel-titanium ring, designed to replicate the performance of the metal V3 but obviously with nothing like the durability. For general clinical questions about the V3 Blue, please refer to the V3 Sectional Matrix System FAQs. Except in one or two areas like retensioning, the same advice applies.

 

Q. Can I autoclave the V3 Blue?

 

A.

The V3 Blue can be autoclaved but we recommend it for single use only.

V4 ClearMetal Matrix System Frequently Asked Questions
Q. Do V4 Rings work equally well on all posterior teeth?

 

A.

Yes. Great effort has been put into V4’s anatomical features and the tooth separation forces applied so that between them, the V4 Molar and Premolar rings will work equally well on all posterior teeth. We believe that no other matrix system compares in this respect. And regardless of whether you make use of V4’s cure-through feature, the ring’s functionality gives it, we believe, the widest indications for use of any matrix ring on the market.

 

Q. Is it necessary to use Triodent Forceps and Pin-Tweezers with the V4 System?

 

A.

We strongly recommend that you use Triodent Forceps and Pin-Tweezers. This isn’t because we can sell more of them, but because they are specially designed to fit our rings, matrices and wedges perfectly. This compatibility means you get optimum grip security and ease of use. Other tweezers, forceps and pliers may damage the V4 components as well as cause you to drop them.

 

Q. What can I do to be sure that the ClearMetal Matrix will slide easily into the proximal space?

 

A.

It always pays to ensure that the interproximal contact is open before placing the matrix. If there is no gap, we recommend using a diamond polishing strip to open it slightly. This makes it easier to position the matrix correctly without deformation, and to view the vertical margins during the procedure, and also to check these margins at follow-up appointments. Bevelling the gingival margin will also make it easier to confirm by sight, inside the box, that you have a proper matrix seal.

 

Q. I want matrix placement to be as easy as possible. Do you have any other tips?

 

A.

Sometimes it is overlooked during the learning stage that you can bend the matrix tab to aid insertion. Grip the occlusal tab of the ClearMetal Matrix with Pin-Tweezers, bend the tab towards you to create a contra-angle, and place the matrix apically in the gingival crevice. It sure beats other matrix insertion methods.

 

Q. How do I know which V4 Wedge is the right size for the interproximal space?

 

A.

It is important to remember that these wedges are only for matrix adaptation, not tooth separation. There are four sizes of V4 Wedge. Each wedge has small notches along the sides that essentially divide it into three segments. When the right sized wedge is used, those segments will contract and expand independently, producing greater matrix adaptation than you will get with other wedges. Deformation can only occur if the wedge is too large for the embrasure. For optimum adaptation of the matrix, choose the largest wedge size that will fit the interproximal space. If the wedge deforms, choose a smaller size. Size selection is critical to make the most of its adaptation capabilities, but becomes simple and routine after a very short time.

 

Q. How do I know which ring to use?

 

A.

The V4 Molar Ring is indicated for most Class II cases but more specifically molars. The V4 Premolar Ring is designed for premolars and primary teeth as it has a stronger action to achieve optimum separation on narrow embrasures. The premolar ring can also be useful for teeth that are difficult to separate or back-to-back cases.

 

Q. Do V4 Rings produce tight contacts?

 

A.

Yes. Triodent sectional matrix systems – using the V4 Ring, V3 Ring or the V-Ring – are the surest way to achieve tight contacts. Some of the functional differences between the V4 System and other sectional matrices are:

  • The V4 Ring is particularly good at holding the matrix in a full anatomical curve.
  • The V4 Ring traps the matrix along the length of the tooth occluso-gingivally, preventing slippage and movement of the matrix away from the neighboring contact point.
  • The V4 Ring spring is made from nickel-titanium (NiTi) and is very resilient.
  • The retention is better.
  • The tooth separation is better as the lateral force of the spring is greater.
  • Its footprint is smaller than that of other standard rings.

It can also be used with circumferential bands to achieve tight contacts and better anatomy. When you think about, it can’t help but produce excellent contacts.

 

Q. Can V4 Rings be used on wide cavities?

 

A.

Yes. The anatomically-shaped tines grip on both adjacent teeth, which prevents the spring from falling into wide cavity preps (as other sectional matrices often do).

 

Q. Can V4 Rings be used when a cusp is missing or on severely compromised teeth?

 

A.

Absolutely. Because the tines grip right down at the gingival margin, V4 is the best matrix ring for a missing cusp, and it will grip even when there is minimal tooth structure – a quality no other matrix ring can match.

 

Q. Can V4 Rings be used on primary teeth?

 

A.

Yes. The V4 Ring comes in two sizes – Molar and Premolar. The Premolar ring is suitable for use with small and primary teeth and on some molars when greater separation force is required.

 

Q. Is the V4 Ring compatible with a Tofflemire-type matrix band?

 

A.

The V4 Ring is more than compatible, it is ideal in many situations. The tines of the V4 Ring grip at the gingival margin, so it works extremely well on large restorations where a circumferential band is preferred. The ring will retain and adapt the matrix without collapsing that matrix into the cavity. At the same time it will produce ideal tooth separation and create far better contacts than are usually achievable with Tofflemire-type matrices.

 

Q. Is there anything I can do to speed up or streamline my workflow when using V4?

 

A.

A really good thing to do is for your assistant to pre-load matrices and wedges in Triodent Pin-Tweezers. The tweezers hold consumables securely in their passive position, so can be ready for use, already loaded, on the operatory table. The same can be done with the V4 Ring in Triodent Forceps with the locking bar engaged, but do not leave the ring extended for too long.

 

Q. What is the best orientation for the V4 Ring to achieve optimum performance?

 

A.

The V4 Ring may be placed mesially or distally, but for optimum light-curing it is better to place the ring in a distal orientation wherever possible.

 

Q. Can V4 Rings be used on MODs?

 

A.

V4 Rings work well on single Class II restorations and MODs. You can stack the V4 Rings or have one facing mesially and the other distally. The ring tilts up, away from the marginal ridge of the tooth, allowing more room for another ring to be placed underneath, on the next tooth. In most cases it is advisable to place the rings in opposite directions.

 

Q. What is the best way to restore an MOD with the V4 Ring?

 

A.

Follow these steps:

1. Pre-wedge both M and D and complete cavity preparation.

2. Slide M and D matrix into position and etch and bond.

3. Place V4 Ring on M and build and cure M contact point.

4. Move V4 Ring to D and build and cure D contact point.

5. Complete occlusal surface and cure.

 

Q. What is the best way to restore a back-to-back MO or DO?

 

A.

The easiest method for back-to-back Class II restorations is to complete one and then the other. Doing both simultaneously can be faster but requires more operator skill. A Premolar V4 Ring is recommended as more separation is necessary to overcome two thicknesses of matrix.

 

Q. When doing an MOD, the ClearMetal Matrix band side extrusions are too long and get in the way of the opposing matrix band. What can I do about this?

 

A.

The easy way around this is to place one ring on the tooth, trapping the matrix band in place, then bend the protruding ends of the matrix backwards to make room for the opposite matrix band.

 

Q. Does the V4 Ring work if you are doing three teeth in a row e.g. #12DO, #13MOD, and #14MOL?

 

A.

Dr McDonald prefers to prep all at once, place matrices on all three restorations and then place initial composite layers on all three. He then finishes layering 12 and 14 and pulls out the matrices on those restorations. Next he pushes the wedge in further between 12-13 and 13-14, burnishes the contact on the M and D of 13 and places the final layer on 13. He then finishes all three at the same time. You may prefer to use multiple rings and do all the restorations at once, but you will need to make sure that the V4 Ring is separating the contact you are working on each time. You can move the V4 Ring along as you work, or stack rings. Dr McDonald prefers to use just one V4 Ring as it allows that embrasure to open rather than have the rings working against each other. Although he builds one contact at a time, he etches, bonds and places bands and/or matrices all at once.

 

Q. Do you have any tips for working with V4 in a very deep proximal cavity to ensure optimum light-curing?

 

A.

Sure. One alternative is, having done a normal cure – laterally and occlusally – remove only the V4 Ring and then cure interproximally with the ClearMetal Matrix still in place. This allows the curing-light tip better access to the deepest part of the restoration and ensures that the composite is adequately cured prior to matrix removal.

 

Q. The V4 Ring is a small piece of equipment to put in the patient’s mouth. What if it springs out or is dropped?

 

A.

The V4 Ring is very stable on wet or dry teeth because of its strength and anatomically shaped faces. However, we stress that rubber dam is mandatory to prevent accidental inhalation or ingestion. For added security, tie a small amount of floss to the ring. And if you use Triodent Forceps, there is much less likelihood of the ring being dropped.

 

Q. Which style of rubber dam clamp should I use on, for example, a #30, that will not interfere with the V4 Ring?

 

A.

Firstly, it is usually better to use a wingless clamp, say a W3 or W7, but there are other options to consider, like an 8a or a serrated premolar clamp. Yet another thing to try is to use a normal clamp, rotated slightly, on the #31.

 

Q. Should I be worried about my contacts being too tight?

 

A.

We at Triodent pride ourselves on the predictability of tight contacts with all of our sectional matrix systems. What might be perceived as over-tight contacts will almost always resolve themselves in a day or two through minor (<30µ) tooth movements similar to orthodontic movements. No awkward disking or stripping of contacts is necessary.

 

Q. Do I need to burnish ClearMetal Matrices?

 

A.

Ordinarily, no. The matrix is already anatomically shaped, so burnishing is not needed unless you want to customize the provided contour. All that is needed to ensure a tight contact point is for the matrix band to be touching the adjacent tooth prior to composite placement. This can be done carefully with a blunt instrument like a ball burnisher or the tips of Triodent Pin-Tweezers if they fit into the preparation.

 

Q. What is your advice on cleaning V4 Rings?

 

A.

Scrub, ultrasonically clean (if you do this routinely with your instruments), and sterilize. After clinical use, scrub the V4 Ring in hot water with soap or detergent using a plastic-bristled brush or similar tool. Do not use sharp or abrasive instruments like a wire brush. If build-up of restoration material occurs, gently lift it off with a blunt, plastic instrument and then polish the tines using a soft brush on a slow handpiece with universal polishing paste. The V4 Ring will not be affected by enzymatic detergents during ultrasonic cleaning, but some chemicals may attack the plastic. If you wish to ultrasonically clean the ring but are concerned about the cleaning solution, put the ring in a beaker with a water/detergent solution and place that in the ultrasonic cleaner to keep the ring away from the chemicals. Steam-autoclave V4 Rings at 134°C. To prevent scratching of the rings, keep them separate from other instruments in the autoclave. Do not use chemical sterilization techniques. Chemical sterilization will void warranty.

 

Q. How many uses can I expect to get from my V4 Ring?

 

A.

V4 Rings are extremely durable and come with a 24-month warranty. They have been tested successfully through 1200 autoclave cycles and are very robust during use. To help prolong the life of the ring, do not over-extend it or leave it extended in forceps for long periods.

V-Ring: Frequently Asked Questions
Q. Do V-Rings produce tight contacts?

 

A.

Yes. Experts agree that Triodent sectional matrix systems – using the V-Ring or the V3 Ring – are the surest way to achieve tight contacts since the lateral spring pressure acts like a McKean orthodontic tooth separator.¹ A V-Ring IS a sectional matrix. The only functional differences between the V-Ring system and other sectional matrices are:
The V-Ring is particularly good at holding the matrix in a full anatomical curve.
The V-Ring traps the matrix on the shoulders of the tooth and prevents it slipping and moving away from the neighboring contact point
The V-Ring spring is made from nickel-titanium (NiTi) and is very resilient.
The V-Ring spans wide cavities.
The retention is better.
The tooth separation is better as the lateral force of the spring is greater.
When you think about it, it can’t help but produce excellent contacts.
¹ Dental Clinics of North America, Vol 45, # 1, Jan 2001, p87.

 

Q. Can V-Rings be used on wide cavities?

 

A.

Yes. The anatomically-shaped tines grip on both adjacent teeth and this prevents the spring from falling into wide cavity preps (like other sectional matrices).

 

Q. Can V-Rings be used when a cusp is missing?

 

A.

Yes. Since the tines grip on both teeth on each side of the contact and also low down near the gingival margin, a V-Ring can often be used when a cusp is missing. Depending on the anatomy, it is sometimes best to build up the bulk of the cusp before placing the V-Ring.

 

Q. Can V-Rings be used on primary teeth?

 

A. Yes. The V-Ring works surprisingly well on premolars and primary teeth.\

 

Q. What degree of separation is achieved with the V-Ring?

 

A.

The ring will create a separation of 60-80 microns. This is greater than the thickness of two Triodent matrices and is sufficient separation to restore two adjacent Class II cavities at the same time.

 

Q. Can V-Rings be sterilized and re-used?

 

A.

Yes. They are designed for re-use and are fully autoclavable.

 

Q. Can V-Rings be used on MODs?

 

A.

V-Rings work really well on single Class II restorations and MOD’s. You can stack the V-Rings or have one facing mesially and the other distally. The ring tilts up, away from the marginal ridge of the tooth, allowing more room for another ring to be placed underneath, on the next tooth. In most cases it is advisable to place the rings in opposite directions. (See next two questions)

 

Q. What’s the best way to restore a back-to-back MO or DO?

 

A.

The easiest method for back-to-back Class II restorations is to complete one and then do the other. Doing both simultaneously can be faster but requires more operator skill.

 

Q. What is the best way to restore an MOD with the V-Ring?

 

A.

The recommended method is as follows:
Pre-wedge both M and D and complete cavity preparation.
Slide M and D matrix into position and etch and bond.
Place V-Ring on M and build and cure M contact point.
Move V-Ring to D and build and cure D contact point.
Complete occlusal surface and cure with C-Factor issues in mind.

 

Q. How can the extra cost of V-Rings be justified?

 

A.

V-Rings are not much more expensive than other competing systems and they produce better results with less frustration and time spent. They are also made of NiTi, which lasts longer. The cost of the consumable V3 Tab-Matrix is similar to other sectional matrix bands. In addition, think how much it costs you every time you have to re-do a proximal restoration because it has a poor contact. If you try to re-do it right away you run late and get stressed out. If you do it later the patient “bad-mouths” you because they think you are incompetent. You lose credibility and waste more time with more costs and no income when you do have to re-do it! Arrrgh!

 

Q. Do V-Rings work equally well on all teeth?

 

A.

The V-Ring is a very versatile system and no other matrix system comes close in this respect.

 

Q. Do I have to hold the contact point with a burnisher while light curing? Could I use a regular matrix and hold the contact and then why would I need a V-Ring?

 

A.

Dr McDonald always does this because it is so easy to do and avoids the bad contact caused by the matrix not being in contact with the neighboring tooth. Quite often it is impossible to see if the matrix is actually touching, so holding is just a precaution. Dr McDonald believes this issue is the single main cause of REALLY bad contacts. The V-Ring’s function is to separate the teeth (orthodontically) and wrap the matrix.

A regular matrix (Tofflemire) when used on a Class II has the effect of moving the tooth in the wrong direction by the thickness of the matrix (because you have to get the matrix through the intact side). This means that you have to overcome TWO thicknesses of matrix to get a tight contact. Tofflemires also tend to produce cylindrical, “tin can”, restorations with a poor contour and a contact just at the marginal ridge. This method has been found to be unpredictable by most who have tried it.

 

Q. Which style of clamp should I use to hold the rubber dam in place?

 

A.

The clamped tooth should be further distal than the one being restored. If that is not possible, then a small clamp can provide more room for the V-Ring. Often there is room for both the clamp and the V-Ring.

 

Q. Does the V-Ring work if you are doing three teeth in a row i.e. #12 DO, #13MOD, and #14MOL?

 

A.

Dr McDonald prefers to prep all at once, place the matrices on all teeth then place composite initial layers on all three teeth. Then he finishes layering 12 and 14 and pulls off the matrix on 12 and 14. Next he pushes the wedge in farther between 12-13 and 13-14, burnishes the contact on M and D of 13 and places the final layer on 13. Then he finishes all three at the same time.

 

Q. With the V-Ring is it best to do them all separately start to finish or would you do 12 and 14 together and then 13 by itself?

 

A.

Yes you can do all four in a row if you want. You just need to make sure that the V-Ring is separating the contact you are working on. You can move the V-Ring along as you work, or stack rings. Dr McDonald prefers to use just one V-Ring as it allows that embrasure to open rather than the retainer rings working against each other. Although he builds one contact at a time, he etches, bonds and places bands and/or matrices all at once.

 

Q. When doing an MOD, the matrix band side extrusions are too long and get in the way of the opposing matrix band?

 

A.

The easy way around this is to place the yellow V3 Ring on the tooth, trapping the matrix band in place, then bend the protruding ends of the matrix backwards to make room for the opposite matrix band.

 

Q. The V-Ring is a small piece of equipment to put in the patient’s mouth. What if it springs out or is dropped?

 

A.

The V-Ring is very stable on wet or dry teeth because of its strength and anatomically shaped faces. However, for added security tie floss to the ring.

 

Q. How do I retension the V-Ring if the tines start to separate?

 

A.

We use NiTi in our rings. It has remarkable strength and elasticity, so the ring will return to its original shape again and again. The V-Ring may separate slightly over time with over-stretching, but can be easily retensioned by placing it in the grooves of the handle of the Triodent forceps. Squeeze it like a nutcracker until the tines touch and the ring is as good as new. To prevent over-stretching, only open the ring as far as is needed to place it over the tooth. Also, try not to leave the ring open in the forceps for a long period of time.

 

Q. What is the best way to remove the matrix band when it’s in a tight contact area and stuck to the composite?

 

A.

Push a thin, metal-blade instrument like a probe through the embrasure below the contact point to break the bond. Some clinicians also recommend flossing between the restoration and the band.

 

Q. How do I get bonding agent off the V-Ring?

 

A.

If your V-Ring has been contaminated with bonding agent, soak it in alcohol for a few minutes to soften the bonding agent. You will then be able to scrape it off. A light smear of Vaseline (petroleum jelly) before use will help prevent contamination.

 

Q. Can I place the Wave-Wedge with the V-Ring in place?

 

A.

Yes. The V-shaped tines of the V-Ring allow you to place a wedge without removing the ring. And because the Wave-Wedge has a hollow underside, you can slide a second wedge from the opposite side to the first.

Triotray Pro-Lock : Frequently Asked Questions
Q. Can I use my existing impression materials?

 

A.

Yes, no problems.

 

Q. How long will a tray last?

 

A.

The stainless steel trays will provide many years of accurate impressions.

 

Q. Where do I buy the trays and inserts?

 

A.

Trays and inserts can be purchased from ourselves or from your lab at the same price.

 

Q. How do I ensure I can keep track of my tray when it goes to the lab?

 

A.

You can have your practice name engraved on the tray – see if your dealer is willing to do it for you.

 

Q. Can I make temporaries?

 

A.

The unique insert design allows you to use the tray multiple times but also remove the insert and impression to keep in case a temporary crown is lost and another casting is needed.

 

Q. How easy is the tray to clean?

 

A.

Your dental assistant will be able to clean each tray of all impression materials in less than 15 seconds to be ready for placement in the autoclave.

 

Q. Do I need to use adhesives?

 

A.

No. The peripheral rim on the tray walls locks in the impression material. Therefore, adhesive is not needed, effectively reducing time and material costs and improving patient comfort.

 

Q. Can I use it with my CAD/CAM system?

 

A.

Triotray Pro-Lock makes a perfect high-quality complement to CAD/CAM systems for any work that is difficult to scan or needs scanning outside the mouth.

 

Q. How long will the 50 inserts in my 10-tray kit last?

 

A.

Based on 4-5 impressions per week, refills will be required after about three months.

 

Q. How long should my Triotray Pro-Lock last?

 

A.

The tray is a one-piece stainless steel instrument with a two-year warranty. We are confident you will get much more than two years of use with this robust instrument.