• How do I use Composi-Tight® when there is a great deal of tooth structure missing, for example a large lingual embrasure?
• My G-Rings® seem to have lost their spring. The tines are farther apart than when they were new.
• My rubber dam forceps do not open the G-Ring® tines far enough.
• Why should I use a metal band rather than a clear matrix?
• I sometimes have difficulty getting the sectional matrix bands in place.
• What if I don't get a good contact?
• What if the tooth/teeth being restored are very far apart?
• My contacts are sometimes too tight, causing discomfort to my patients.
• I have trouble removing the bands due to the tightness of the contact.
• How do I restore a back-to-back MO and DO?
• Can Composi-Tight® be used with amalgam?

There are two possible options:
If the wide embrasure is on the lingual side, then wedge from the lingual. Place the tine of the G-Ring on the outside side of wedge, opposite the tooth being restored (see diagram 2b. on instruction card).

Fill and cure all but the interproximal area. This can be done by building up the wide embrasure area freehand or by using a Tofflemire band. Then place a Composi-Tight contoured matrix and G-Ring® to complete the restoration for a contoured tight contact. Great news! This is one of the improvements with the new Composi-Tight Gold rings. The rings are now 2x stronger than the original rings for greater separation, plus will retain their shape and tension longer.

However, this doesn't mean the original rings can't last long. Here are some helpful hints:

• Open the rings only as far as needed to place them over the tooth, without over stretching.
• Do not leave the rings open in the forceps for long periods of time.
• If they do lose their original tension, the tines can be brought back together by gently pinching around the ring with three-prong pliers or orthodontic headgear pliers. The rings will regain their original shape but the tension will be diminished each time this is performed.

back to top G-Rings® are designed with a circumference that allows them to be opened by the majority of ivory-style rubber dam forceps, while also maximizing the life and tension of their spring. Some forceps, however, do not spread the tines open far enough for certain applications. Garrison Dental Solutions offers a G-Ring Placement Forceps ($49 each separately or $37 with kit order) that is ideally suited for this task (Click here to view animation). They will open the ring far enough for all applications while reducing the risk of over-spreading and fatiguing the rings. They are designed with a broad notch for gripping the ring tightly, so that the ring will not slip off inadvertently during placement. They also make placement of multiple rings easier since there are no tips on the end of the forceps as on standard rubber dam forceps.

Sometimes the reason for inadequate spreading of the tines is that the rubber dam forceps themselves are flexing. Grasping the G-Ring tines higher up the collar of an ivory style forceps (rather than at their tips) can reduce this flexing, allowing the ring to open farther.

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• If the prep is filled and cured incrementally there is no need for a clear matrix.
• A metal band can be manipulated (burnished, shape adjusted) and formed without the matrix band bending or flexing like a clear mylar matrix band.
• Light reflects back into the restoration when curing occlusally.

back to top Because of their anatomical curvature, Composi-Tight® bands are a little more difficult to place than a non-contoured Tofflemire band. Several options can help:

1. Break contact with the adjacent tooth with a very fine diamond. You will regain this contact, and you will not leave unsupported enamel. Slide the band in laterally (from buccal to lingual or vice-versa, instead of occlusally): First grasp the band with a high quality dressing forceps (or the GDS Band Placement Forceps). Then pre-curl the band to approximate the tooth's curvature. Drag the band through the interproximal area. This will prevent the band from hanging up on the gingival floor of the tooth being restored.

[Note: Sometimes the curvature of the band may make dragging the band laterally into place appear difficult since the cheek may be in the way of the forceps. Bending the outside edge of the band where the forceps is grasping it easily solves this.]

2. If a very conservative preparation is desired where the contact with the adjacent tooth is not broken, try placing the G-Ring® on while the preparation is being cut. This will allow the teeth to separate for a longer period of time. Then remove the ring and insert the matrix band as described above. Now the ring can be replaced and the restoration completed.

3. A third option is to use a section of a Tofflemire band along with the G-Ring®. Additional burnishing will be required to achieve contour, but the benefits of using the rings for separation instead of solely relying on a wedge will result in a better contact than solely using a Tofflemire retainer and wedge.

4. The small size sectional matrix bands are often easier to place than the standard or large sizes. They are also the more commonly used size for bicuspids and many molar restorations.

back to top Remember to burnish the band against the adjacent tooth, and always use a G-Ring.

back to top Composi-Tight® will expand further than a standard matrix, but there are some gaps that no matrix can repair.

back to top Wedge lightly using a small WedgeWand®. The intent of the WedgeWand® is to hold the band tight to the tooth, sealing off the gingival margin. The wedge is not required for separating the teeth. Let the G-Ring® do the separating. If a tighter contact is desired, a more firm wedging combined with the force of the G-Ring will achieve this.

back to top Due to the contour of the band and the tightness of the contact, removing the band cannot be achieved with cotton pliers. GDS offers Band Placement Forceps that are ideal for this purpose. They have fine teeth that engage with one another, allowing the band to be removed easily. Hemostats or Howe pliers are also adequate for removing the band.

back to top We recommend first restoring one side using only the band and wedge. Then, restore the opposite side by applying the band, wedge and G-Ring®. For contact, be sure to burnish the band against the previously restored side. You may want to refer to the November/December 1998 issue of Contemporary Esthetics & Restorative Practice for a Quick Tips article written by John Garrison, DDS, a developer of the Composi-Tight® system.

back to top The system was designed, developed and tested for use with composites. Contacts will be good, tight and broad at the height of contour, however, if the amalgam is not fully set it is possible to fracture the amalgam when removing the band. Now that the final problem with posterior composite fillings has been solved (getting good contacts), why use amalgam?