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How to build interproximal areas

Dr. Dipesh Parmar breaks down two key procedures you can follow when doing a interproximal wall build up.

Dipesh Parmar
13 October, 2020
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When restoring a patients tooth, it’s vital that you get the build up of the interproximal wall just right. After all, it will determine the overall shape of the restoration. 

When looking to build up the interproximal areas, there are two approaches you can take:

  1. The immediate approach – Done immediately after the palatal shell and before the dentine build up.
  2. The delayed approach – Done after the palatal shell and the dentine build up. The interproximal areas are restored when doing the final enamel mass.  

The break down – Immediate approach

Once you have created the palatal shell insert an interproximal matrix and use the aid of a wedge to stabilise it. Next, get a small increment of resin and insert it into the interproximal area. Sculpt a model of the composite in order to form an appropriate shell and light cure the composite against the interproximal matrix. By following this method, once the matrix is removed, you will have a palatal shell along with an adjoining interproximal shell.

The break down – Delayed approach

The delayed technique is used by the majority of dentists. Having completed the palatal shell and the dentine build up, insert an acetate matrix and secure that with a wooden wedge. Apply the final increment of resin (the enamel mass) and as you’re shaping it on the facial surface pack the composite interproximally. Finally, apply some modelling resin on to the Mylar strip, and using the Mylar pull through technique, pull the strip from the buccal towards the palatal. By doing so you will essentially drag the composite to form the interproximal wall.


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