Class II Amalgam Restoration

#29 DO

Overview

  • Occlusal

     all centric and excursive contacts on the restoration are consistent in size, shape, and intensity with such contacts on other teeth in that quadrant

  • Proximal

    marginal ridge should be at the appropriate height proximal contour and contact area should be correct

Armamentarium

Instruments and Materials

Video Demonstration

Procedures

A
B
C
  • Ensure the matrix band rises 1mm over the marginal ridge
D
  • Insert the wedge from the lingual using the forceps
E

Instrument suggestions: ball burnisher, amalgam condenser

F
  • Properly triturated amalgam: homogenous consistency
  • Over triturated amalgam: hot, shiny, soupy, stick to the wall of the capsule, and will set quickly
  • Under triturated amalgam: dry and crumbly
G

Caution: do not touch amalgam with bare hands

H

Work swiftly as amalgam sets fairly quickly

I
J
  • Begin condensing in the proximal box
  • Apply sufficient force when condensing amalgam ​
K
L

Use the larger amalgam condenser when the amalgam fill reaches the occlusal surface

M
N
O
  • Loosen the short swivel to release the matrix band from the matrix band holder
  • Remove the interproximal wedge with forceps
  • Remove the matrix band from the side opposite of the proximal box
  • Lightly hold down the amalgam with an instrument and carefully remove the remaining portion of the matrix band in the bucco-occlusal or linguo-occlusal direction
    • Removing the matrix band in the occlusal direction may dislodge the restoration
P
  • Remove excess amalgam from the proximal aspect and overhang at the gingival margin

Instrument options: explorer, proximal carver

​​

  • Develop occlusal anatomy by guiding the instruments along the remaining tooth structure to create grooves and correct cuspal inclines

Instrument options: acorn burnisher, cleoid-discoid, Hollenback carver

Q

Instrument options: explorer, Hollenback

R

Instrument options: small ball burnisher

S
T
  • Floss in the gingival direction and pull laterally through embrasure to avoid dislodging the restoration <br>
  • Proper contact should give light resistance and create slight “snap” sound
U
V
  • Areas of hyperocclusion will mark heavily with the articulating paper <br>
  • Adjust areas where the restoration is “high”

Instrument options: amalgam carver or cleoid-discoid

W
  • Polishing is performed after amalgam has set, according to the manufacturer’s instructions
  • Smooth the surface using rotary instruments (slow speed)

Bur options: rubber cup and pumice, Duragreen polishing bur or Brownie polishing bur

​

  • Shine the surface using rotary instruments (slow speed)

​

Bur options: Greenie polishing bur

X
  • Use the explorer to ensure that there is a smooth transition between the restoration and remaining tooth structure

Checklist

Common Mistakes

References

Hilton, T. J., Ferracane, J. L., &amp; Broome, J. C. (2013). Summitt’s fundamentals of operative dentistry a contemporary approach. Quintessence Publishing Co. Inc. 
Ritter, A. V., Boushell, L. W., Walter, R., &amp; Sturdevant, C. M. (2019). Sturdevant’s art and Science of Operative Dentistry. Elsevier. 

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