V-Ring Frequently Asked Questions (FAQ)

V-Ring Questions
1. Do V-Rings produce tight contacts?
2. Can V-Rings be used on wide cavities?
3. Can V-Rings be used when a cusp is missing?
4. Can V-Rings be used on primary teeth?
5. Can V-Rings be sterilized and re-used?
6. Can V-Rings be used on MOD's?
7. How long do V-Rings last??
8. Can you use V-Rings to restore TWO adjacent Class II cavities?
9. Do V-Rings work equally well on all teeth?
10. How do V-Rings and Tri-Clips compare?
11. 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?
12. Which style of clamp should I use to hold the rubber dam in place?
13.Does the V-Ring work if you are doing three teeth in a row i.e. #12 DO, #13MOD, and #14MOL?
 

Tab-Matrix Questions
1. How do I use the Tab?
2. How do I prevent the little tab blocking my view of the cavity?
3. How do I remove the Tab-Matrix?

V-Ring Questions

1. Do V-Rings produce tight contacts?
Yes! Experts agree that sectional matrix systems are the surest way to achieve tight contacts since the lateral spring pressure acts like a McKean orthodontic tooth separator1.
A V-Ring is a sectional matrix. The only functional differences between the V-Ring system and other sectional matrices are:

1. The V-Ring is particularly good at holding the matrix in a full anatomical curve.
2. The V-Ring traps the matrix on the shoulders of the tooth and prevents it slipping and moving away from the neighbouring contact point
3. The V-Ring spring is NiTi and is very resilient.
4. The V-Ring spans wide cavities.
5. The retention is better.
6. The tooth separation is better as the lateral force of the spring is greater.

When you think about, it can't help but produce excellent contacts.
1. Dental Clinics of North America, Vol 45, # 1, Jan 2001, p87.
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2. Can V-Rings be used on wide cavities?
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).
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3. Can V-Rings be used when a cusp is missing?
Yes! Since the tines grip on both teeth either 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 cusp before placing the V-Ring.
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4. Can V-Rings be used on primary teeth?
Absolutely! V-Rings work surprisingly well on primary molars.
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5. Can V-Rings be sterilized and re-used?
Absolutely! They designed for re-use.
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6. Can V-Rings be used on MOD's?
V-Rings work really well for single Class II restorations and MOD's. You can stack the V-Rings or have one facing mesially and the other distally.
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7. How can the extra cost of V-Rings be justified?
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 stainless steel and NiTi which lasts longer. The cost of the consumable 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 loose credibility and waste more time with more costs and no income when you do have to re-do it! Arrrgh!
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8. Can you use V-Rings to restore TWO adjacent Class II cavities?
Yes. The separation that V-Rings generate is 60-80 microns, which is greater than two thicknesses of matrix.
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9. Do V-Rings work equally well on all teeth?
The V-Ring is a very versatile system and no other matrix system comes close in this respect.
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10. How do V-Rings and Tri-Clips compare?
The V-Ring costs more in the beginning but this cost decreases per restoration. It takes a tad longer to place but saves time on finishing and, in my hands, produces the most anatomically correct restoration I have ever done. The V-Ring is more versatile that the Tri-Clip and works well in some really tricky situations. It is also easier to learn how to use. The Tri-Clip costs less to get started but costs more per use (compared to the V-Ring). In my experience the TriClip works well on the first molar forward but is harder to get in place further back, particularly in the maxilla.
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11. 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?
I always do this because it is so easy to do and avoids the bad contact caused by the matrix not being in contact with the neighbouring tooth. Quite often it is impossible to see if the matrix is actually touching so holding is just a precaution. I reckon that this single issue is the main cause of REALLY bad contacts. The V-Ring's function is to separate the teeth (orthodontically) and wrap the matrix. Just as an aside, I prefer to add a tad more curvature with my fingers before placing the matrix as it makes more room to place the V-Ring.
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. Tofflemire also tend to produce cylindrical restorations with a poor contour and a contact just at the marginal ridge. This method has been tried over and over and found to be be unpredictable by most who have tried it.
Have you watched Graeme Milicich’s presentation? Follow the link on our homepage http://www.triodent.com It covers a lot of very useful ground and is free to watch!”
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12. Which style of clamp should I use to hold the rubber dam in place?
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.
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13. Does the V-Ring work if you are doing three teeth in a row i.e. #12 DO, #13MOD, and #14MOL?
I prefer to prep all at once, place the matrix on all teeth then place composite initial layers on all three teeth. Then I finish layering 12 and 14 and pull off the matrix on 12 and 14. Then I push the wedge in farther between 12-13 and13-14, burnish the contact on M and D of 13 and place the final layer on 13. then I finish all three at the same time. 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 ?
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. I personally prefer to use just one V-Ring as it allows that embrasure to open rather than the retainer rings working against each other. Although I build one contacts at a time, I etch, bond and place bands and/or matrices all at once.
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Tab-Matrix Questions
1. How do I use the Tab?
2. How do I prevent the little tab blocking my view of the cavity?
3. How do I remove the Tab-Matrix?

Tab-Matrix Questions
1. How do I use the Tab?
You simply bend the tab towards you (mesially) and hold it with any kind of tweezers and then move it apically into the embrasure. Try to avoid trapping gingival tissue between the matrix and the gingival margin of the cavity.
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2. How do I prevent the little tab blocking my view of the cavity?
While burnishing the Tab-Matrix, lift the tab over and fold it out of the way.
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3. How do I remove the Tab-Matrix?
First lift the matrix away from the restoration to un-stick the adhesive. Then use the special TrioDent Pin-Tweezers and grab the hole on the wings of the Tab-Matrix and simply pull. Grabbing the Tab often rips the tab off but the lateral holes work better.
You can also try flossing (waxed floss) between the matrix and the restoration.

In the above image, note how the Tab-Matrix has been peeled away from the restoration so that it can be rotated about the contact point. It will then slide out easily if you have a good grip with either the Pin-Tweezers or hemostats.
Please note that the Tab is ONLY for placement and NOT for removal.
We are convinced that the bonding agent glues the matrix to the composite so it is essential to unstick the matrix with a probe or flat instrument, rather than keeping on pulling at the matrix.
Once you have separated the matrix you should be able to wiggle it so that it rotates about the contact point. It then can be wiggled out relatively easily even though you have a very tight contact.
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