Back To Basics - Mind The Wedge

23/4/2020 Back to Basics: Mind the Wedge - styleitaliano.
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RESTORATIVE & ADHESIVE
Back to Basics: Mind the

Wedge
a 1 August 2017  by Giuseppe Chiodera  Views 84,755
Why mind the wedge?What do I expect a wedge to do for me?

Well, mainly, posterior direct second class restorations. Those
need special recipes. We have to mix good materials, protocols our skills
and experience, and sometimes our fantasy; even if we follow the
protocols, every second class is different from all the others we have 
done in the past, and the ones we will do in the future.
I would like to focus our attention on one of the most important points of
the chain, the wedge, and try to answer the former question: what do I
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23/4/2020 Back to Basics: Mind the Wedge - styleitaliano.org
expect a wedge to do for me?

1) To create space by properly separating teeth to compensate for the
space between the teeth that the dam and the matrix are going to make
me lose.

Fig.1
The ring is really helpful,
but only to make the
matrix t better, the size of
the matrix remains to be
compensated.
2) To allow the cervical t
of the matrix: this one is a
real challenge because we
don’t want the wedge to
change the matrix shape.
Fig.2
What I need, is to give the
right pressure only in the
cervical area (light green).
The parts of the wedge
that remain out of this
area are not important for
the purpose.

CHOOSING AND USING THE
RIGHT WEDGE
Choosing the proper wedge
size
Fig.3
Now, what about the
choice of the wedge? We 
should know the size of
the wedges and the
proportions between the

measurements of the
di erent wedge colors. (In
the picture, ex Polydentia
wedges)
Fig.4
Most of the wedges have a
rectangular shaped
section. Among them, blue
and pink in section have
the same height but
di erent widths, yellow
and green have the same
width but di erent heights.
Only the white wedge has
the same height and width,
meaning a square section.
Fig.5
Di erent wedges ll the
interdental space in
di erent ways

How to insert the wedge
Fig.6
We want to separate the
teeth e ectively, but we
must analyze the space
where we will have to work
rst, in order to choose the
best wedge insertion. 
Fig.7
By observing the
interdental spaces on the
occlusal side, we see that
buccal and lingual/palatal
interdental angles may
have di erent shapes and
combinations

Try in of the wedge
Fig.8
Try in of the wedges from
the buccal side
Fig.9
Try in of the wedges from
the lingual side. It is
important to try both ways
because we usually only
use the buccal one, even if
in many clinical situations
it is better to use the other
insertion.
Fig.10
TIP: Try in of the wedge
should be carried out
before placing the matrix.
In this case the wedge
from the lingual side has
the better angle to ll the
space. This will be our

choice.
Fig.11
Sometimes, even on the
same tooth, wedges should
be placed di erently on
the mesial and on the
distal side.

But what should a wedge
do?
Fig.12
It shouldn’t interfere with
the curvature of the matrix
Both standing in the way of
the wedge, ot it leaning on
the margin represents a
problem for the future
contact point, both for the
margin adaptation of the
composite and oral hygiene
managment in that area.
Fig.13
To open this space it is
possible to cut the wedge
in a couple ways
Fig.14
Using a bur outside the
mouth 
Fig.15
Using a blade (#11 is the
best) outside the mouth
Fig.16
TIP: An option is to put the
wedge in the interproximal
space and then nish the
cavity. In this case, it is
important to have a tool to
pull the wedge and re-
insert it in the same
position.
Fig.17
This way we will mold our
custom wedge for that
cavity.
Fig.18
This is the result: now the
matrix can close the space
between teeth as the
wedge does not interfere.
Fig.19
TIP: Another option not to
interfere with the matrix is
to put the wedge
horizontally. It also gives
more pressure than
vertically.
Fig.20
If the contact point is low
and the best matrix
concavity is required to
give the wall a proper
convexity, it is possible to
put the wedge horizontally
with the peak oriented in
the direction of the cavity;
it will be important to use
strips to nish the
restoration in the cervical
area.
Fig.21
If the contact point is high
you can put the wedge
horizontally with the base
oriented in the cavity
direction: it makes the
matrix t better and there
is a lot of pressure in the
cervical area .
Fig.22
Finishing the margin while
the wedge is horizontally
placed: the bur could not
touch it.
Fig.23
It shouldn’t drag the dam
We need to control the
operating eld. We want to
protect adhesion
procedures from saliva,
blood and breath.
Fig.24
To avoid dragging of the
dam we can use some
liquid soap.
Fig.25
Or just cut the tip of the
wedge, in the area we have
seen it is not important to
stabilize the matrix, so the
pressure will only be where
you need it, and the tip will
not drag the dam
Fig.26
Same case with the wedge
made “shorter”
Fig.27
Matrix in place, the wedge perfectly works.
CONCLUSIONS
The wedge is a fundamental step to achieve a good second class
restoration
Unfortunately it is often put in an automatic way without taking advantage
of the real help it can provide.
Dedicate a few seconds to find the best wedge and the best way to use it 
to really make the difference between a success and a Success.
It is part of the steps that are needed to get an interproximal wall; it is
made from many single easy points to follow; it is the only case in which
many points do not make a line but a point… a contact point .
4 Comments Sort by Top
Add a comment...
Javier González Fuentealba

Great tips
Like · Reply · 44w
Ahlawy Magdy
Thnx for these tips
Like · Reply · 1y
Assila Optimiste
Very interesting this step, unfortunately it us often missed by some
practitioners. Thnx so much for sharing your article
Like · Reply · 2y
Zeina Baz
Great artical
Like · Reply · 1y
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Tags: COMPOSITE ISOLATION MATRIX POLYDENTIA
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ABOUT AUTHOR
GIUSEPPE
CHIODERA
My name is
Giuseppe
Chiodera , i
was born
born in
1979 in
Brescia . I
graduated
in 2004 at
University
Of Studies
Brescia ,
the town
where i live
placed in
between
mountains
and lakes .
My activity
is focused
on
diagnosis , detect and manage caries lesions in the very early stages. Thanks to the
university of Bern and Ginevra i had the opportunity to follow that street meeting great
reserchers . Today my passion is Aesthetic and Conservative Dentistry , especially find new
tips and tricks . My professional hobbies are Diode Laser and Ozone . I have the pleasure
and the opportunity to do lectures in different university masters and course, a great
chance to share ideas and learn .
CASES AND PRODUCTS 
One ring, perfect contact point – 24 options for second class cavities:
the Diamond 24
31 May 2018
Custom rings reloaded, updates and indications
14 December 2017
Matrix placement hack: distal areas
21 July 2017

POLYDENTIA

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23/4/2020 Back to Basics: Mind the Wedge - styleitaliano.

RESTORATIVE & ADHESIVE

Back to Basics: Mind the

Why mind the wedge?What do I expect a wedge to do for me?

expect a wedge to do for me?

proportions between the

4 Comments Sort by Top

Javier González Fuentealba

Tags: COMPOSITE ISOLATION MATRIX POLYDENTIA

4 Previous post Next post 5 

CASES AND PRODUCTS 

Custom rings reloaded, updates and indications

Matrix placement hack: distal areas

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