An Improved Quadrant Class II Composite Technique.

When a quadrant of Class II composite resin restorations shows up on our schedule, do we look forward to that work, or do we feel a small sense of dread? When I adopted the use of a dental microscope 20 years ago in my practice, most of the procedures got better, and eventually some got faster. However, until recently, I was never thrilled with either the clinical outcome or the amount of time spent on doing quadrant Class II composites. In this article, we will examine a modern approach with nonretentive saucer preparations, matrixing, and injection molding with a balance of bulk flowable and regular paste strategies. Today, the process can truly be better, faster, and more enjoyable. In a previous article, “The Seven Deadly Sins of Traditional Class II Restorations” (Dentistry Today, January 2017), I listed several “sins” of posterior composites. Two of the sins were burnished metal matrices and weak/worn out separators (Figure 1). There is a legacy problem with the way we think about posterior composite. Traditional wedges, matrices, separators, and boxy cavity preparations never gave us the freedom to create the forces needed to separate the teeth aggressively, and the resultant contours of the restorations were badly compromised by the shape and the flimsiness of thin sectional metal matrices. We have found that the bigger the wedge, the flatter the filling, the smaller the contact; and when we did back-to-back restorations, the problems compounded. That brings us to one of the most common questions that comes up, in fact at almost every one of my lectures—how to best do back-to-back posterior composites? Until now, we have had the following 2 choices: RESTORATIVE