Building up tooth contact and contour

1. CONTACT AND CONTOUR

2. CONTACT POINT/AREA
• That part of the
proximal surface of a
tooth which touches
the adjacent tooth
mesially or distally.
• Synonyms: contact
point, point of proximal
contact.

3. • Initially after eruption the
tooth has a contact point
with adjacent teeth.
• Physiological tooth
movements result in the
wear of the proximal
surfaces causing the
contact point to become
contact area.

4. FUNCTION OF PROXIMAL CONTACT
1. Prevents food from impinging in
between teeth.
2. Stabilizes all the teeth in the dental
arch.
3. Diverts food towards the buccal and
lingual areas thus protecting the
interdental papilla.

5. LOCATION OF CONTACT AREA
MAXILLARY TEETH
• Incisal view shows the contact areas of all maxillary
anterior teeth to be located at the center of the
tooth crowns in a labio-lingual direction.
• The lingual embrasures widen out more than the
labial embrasures.

6. • A labial view shows the contact areas on the mesial
surfaces of the central incisors to be in the incisal
third of the crowns.
• In between the central & lateral incisors contact area
is approximately at the junction of the middle and
incisal thirds of the teeth.

7. • The contact area on the distal surface of the
laterals is in the middle third of the crowns.
• The mesial contacts on the cuspid teeth are
nearly at the junction of their incisal and
middle thirds.
• The contact areas on the distal of the cuspids
is located in the middle third of the crowns.

8. • The contact areas on the mesial surfaces of
the first bicuspids are centered at the junction
of the occlusal and middle thirds of the
crowns.
• The contact areas on the distals of the first
bicuspids are located in the occlusal thirds of
the crowns.

9. • A buccal view shows the contact areas of upper first
& second premolar & first molar to be located in the
occlusal thirds of the crowns.
• An occlusal view indicates that the centers of the
contact areas are located somewhat buccally to the
midline of the bicuspid teeth and usually at about
the midline of the first molar teeth.

10. • A buccal view shows the centers of the
contact areas to be located at about the
junction of the occlusal and middle thirds of
the first and second molar crowns.
• An occlusal view indicates that the contact
areas are broader and are centered at about
the midline of the teeth.

11. MANDIBULAR TEETH
• An incisal view shows the contact areas of all mandibular anterior teeth
to be located at the center of the tooth crowns in a labio-lingual direction.
• A labial view indicates that the contact areas of the mandibular anterior
teeth are uniform in nature and occur at the incisal third of the tooth
crowns.

12. • Buccal view shows the distal contact areas of
the cuspids to be in the middle thirds of the
crowns.
• An occlusal view shows the centers of the
contact areas to be located at approximately
the midline of the teeth.

13. • A buccal view shows the contact areas between
first& second premolar & first molar to be placed
higher than on the mesials of the first bicuspids.
• They are located entirely in the occlusal thirds of the
crowns.
• Occlusally the contact areas are progressively
broader from the first bicuspids distally to the
second molars.

14. • The contact areas between the First, Second and
Third Molar Teeth are located near the junction of
the middle and occlusal thirds of the tooth crowns.
• Occlusally the contact areas are located near the
midline of the crowns with only a slight tendency to
be located toward the buccal.

15. CONTOUR
 Refers to the outline of a structure.
 The facial and the lingual surfaces of teeth possess
some degree of convexity.
 Height of contour-a line encircling a tooth
representing its greatest circumference

16.  The height of contour is generally located at
the cervical third of the facial surfaces of all
teeth & the lingual surfaces of the incisors
and canines.
 The lingual surfaces of the posterior teeth
usually have their height of contours in the
middle third of the crown.

17. FUNCTION OF NORMAL TOOTH CONTOUR
 Provide a degree of protection to the
periodontium by preventing food
impingement against soft tissues.

18. EMBRASURES
 These are V-shaped spaces that originate at the
proximal contact areas between adjacent teeth.
 They are named according to the direction towards
which they radiate.
 These embrasures are facial, lingual, incisal/occlusal
& gingival.

19. Ridge—Any linear elevation found on the surface of a tooth.
Marginal ridge—
1.They are elevations of enamel which form the mesial and distal
margins of the occlusal surfaces of posterior teeth.
2.They also form the mesial and distal margins of the lingual
surface of anterior teeth

20.  Marginal ridges are at uniform heights with
adjacent marginal ridges.
 This relationship is necessary to provide the
most efficient spillways for the deflection of
food substances.

21. HAZARDS OF FAULTY REPRODUCTION OF
CONTACT & CONTOUR

22.  BROAD CONTACT
1.Changes the anatomy of
the interdental col.
2.Produces a less
cleansable interdental
area.
3.May encroach on the
embrasures.
 NARROW CONTACT
1. Causes food to be
impacted vertically/
horizontally in the col area.
2.Predisposes to
periodontal and caries
problem.

23. OCCLUSALLY PLACED
CONTACT
GINGIVALLY PLACED
CONTACT
CONTACT AREA PLACED
TOO GINGIVALLY
1.Impinges on the
interdental papilla.
2.The contact size is
decreased.
CONTACT AREA PLACED
TOO OCCLUSALLY
1. Shallow occlusal
embrasure.
2. Flattened marginal
ridge.

24. • OPEN CONTACT
1.Allows for food impaction in the region of
the interdental col.

25. IMPROPER CONTOUR
• UNDER CONTOUR:
Causes food impingement of food into soft tissue.
• OVER CONTOUR:
Deflects food away from gingiva resulting in understimulation of
supporting tissues.
PROPER CONTOUR UNDER CONTOUR OVER CONTOUR

26. IMPROPER MARGINAL RIDGE
A MARGINAL RIDGE WITH NO OCCLUSAL EMBRASURE
A MARGINAL RIDGE WITH EXAGGERATED OCCLUSAL EMBRASURE
Causes driving of food debris interproximally.
If debris are trapped in between it will be very
difficult to remove.

27. MARGINAL RIDGES NOT COMPATIBLE IN HEIGHT
Restoration with marginal ridge higher than adjacent tooth:
• Will cause the restored tooth to move.
• Dives food debris interproximally.
Restoration with marginal ridge lower then adjacent tooth:
• Major movement of the unrestored tooth occurs.

28. OVERHANGING GINGIVAL MARGIN
Predisposes to periodontal diseases.

29. DITCHING IN THE OCCLUSAL SURFACE
• A deficiency of amalgam along the margin,
preventing the margin of the cavity
preparation from being flush.

30. PROCEDURES FOR CREATING PROPER
CONTACT & CONTOUR

31. INTRAORAL PROCEDURES
1. Tooth movement
a)Rapid tooth movement
b)Slow tooth movement
2. Matricing

32. Rapid tooth movement
• Should not exceed the thickness of the
tooth’s PDL(0.2-0.5 mm).
• Types:-
a)Wedge method:-
1.Elliot Separator
2.Plastic/Wooden wedges
b)Traction method:-
1.Non-interfering true separator
2. Ferrier double-bow separator

33. ELLIOT SEPARATOR
• Used for short duration separation.

34. WOOD/PLASTIC WEDGES
FUNCTION:-
1.Adapts the matrix band to the tooth
gingivally.
2.Occupy the space filled by gingival
interdental tissue thus preventing overfill.
3.Creates tooth separation compensating
for the thickness if matris band
4.Protects interproximal tissue.
5.Immobilizes the matrix band.

35. Special types of Wedge placements
• DOUBLE WEDGING:-
1.Used when the proximal
box is wide faciolingually.
2. two wedges are used, one
from the lingual
embrasure and one from
the facial embrasure.

36. • PIGGY BACK WEDGING:-
• This type of wedging is
particularly useful for
patients whose
interproximal tissue
level has receded.
• Second (usually smaller)
wedge may be placed
on top of the first to
wedge adequately the
matrix against the
margin

37. • WEDGE-WEDGING:-
• Used in case of a fluted
root, such as the mesial
surface of the maxillary
first premolar.
• A gingival margin located
in this area is concave.
• To wedge a matrix band
tightly against such a
margin, a second pointed
wedge can be inserted
between the first wedge
and the band.

38. NON-INTERFERING TRUE SEPARATOR
• A single-bowed
separator designed to
give greater access to
the surface being
operated on; designed
by Harry A. True.
• Indicated when
continuous stabilized
separation is required.

39. FERRIER SEPARATOR
• A set of balanced, double-bowed, adjustable
separators designed by W.I. Ferrier.

40. Slow separation
• Used when rapid movement will endanger the
condition of the PDL (eg. in tilted/drifted tooth).
METHODS:-
a)Separating wires
b)Oversized temporaries
c)Orthodontic appliances

41. MATRIX SYSTEMS

42. CLASSIFICATION OF MATRICES
• Depending upon method of retention:-
a)Mechanically retained eg. Ivory matrix
retainers, Tofflemire system.
b)Self-retained eg. Copper/Stainless steel bands.
• On basis of transparency:-
a)Transparent matrices eg. Cellophane/celluloid.
b) Non-transparent matrices eg. Stainless steel

43. Requirements of a matrix band
• Rigidity-To withstand the condensation
pressure.
• Versatility-To conform to any form.
• Comfortable to the patient.
• Height -A matrix band should extend 2mm
above the marginal ridge height & 1mm below
the gingival margin.
• Easy application & sterilization.

44. Dimensions of matrix bands
• Width-Ranging from
6.35mm to 9.525mm
for permanent teeth.
• 3.175mm to 7.9375mm
for deciduous teeth.
• Thickness-
0.0381mm(0.0015in)
to0.508mm(0.002 in).

45. TOFFLEMIRE/UNIVERSAL MATRIX
• Designed by B.R. Tofflemire.
• Ideally indicated when three surfaces (i.e., mesial,
occlusal, distal) of a posterior tooth have been
prepared.
• It may be positioned on the facial or lingual aspect of
the tooth.

46. WINDOW MATRIX
• Used for Class V amalgam restoration.
• Formed from Tofflemire matrix/Copper band.
• A window is cut in the matrix band slightly
smaller than the original cavity dimension.

47. IVORY MATRIX NO.1
• Indicated in unilateral Class II conditions.

48. IVORY MATRIX NO.8
• Indicated in bilateral Class II/MOD situations.

49. Retainerless matrix systems
• Indicated in tilted or partially erupted teeth.
• Types:-
1.Retainerless automatrix band.
2.Anatomical matrix band
3.T shaped matrix band.
4.S-shaped matrix band
5.Full circle/Ring bands.

50.  The automatrix system
is an alternative to a
universal retainer.
 There is no retainer
used to hold the band in
place.
 Bands are already
formed into a circle and
are available in assorted
sizes in both metal and
plastic.

51. Compound-supported matrix.
• The compound supported matrix is rarely
used,
• but it is an alternative to the Universal matrix.

52. S-shaped matrix
• Ideally used for
restoring distal part of
canine & premolar.
• Normal stainless steel
band is shaped by a
mouth mirror handle.

53. Anatomic matrix & wedges
1. Most efficient means of reproducing contact & contour.
2. Contoured specifically for each individual case.

54. Sectional Matrices
• A thin polished PALODENT-
type band and a tension
ring produce a tight
anatomic contact for class II
restorations.
• Precontoured and ready for
application to the tooth
• most suitable for
mandibular first premolars
and the distal surface of
maxillary canines.
BiTine® ringsMetal matrix forms

55.  A plastic matrix, also referred to as a celluloid
matrix or mylar strip, is used for class III
and IV restorations.

56.  CERVICAL
MATRICES -
 The thin edges allow
the excess composite
to flow out and offer a
closer rebuild of the
natural tooth.

57. 1.These are stock plastic
crowns which can be
adapted to the tooth
anatomy.
2.In bilateral class IV
entire crown form is
used.
3.In unilateral
situations it is cut into
half.