Review of alternative technique for GICs

A while back, I explored a technique idea for getting stronger contacts with GICs:

http://dental-tidbits.blogspot.com/2018/08/getting-good-contact-with-large-gics.html

Thinking back on this technique, I don't think it's a good idea because the premise involves compacting the GIC after the gel stage i.e when there is some solidity to the material and it has lost it's sheen. Prof. Ian Meyers maintains that the best bond to tooth structure will be if the GIC is placed against the tooth while it is still flowy and shiny however this method involves manipulation of the material after this stage. Unfortunately, even light compaction of the GIC is likely to cause movement of the material away from the tooth that will lower or even completely remove its bond strength. This is likely why there was a restoration fracture soon after placement.

Alternative techniques would be to place a wooden wedge with or without a V ring to get a very tight contact initially with the GIC. If there is an open contact after restoration, you can cut it back on the spot and place a composite resin in a sandwich technique or do this a few days later. If the adjacent tooth is very distant you may even leave an open contact that is cleansable as closing this contact will likely be difficult and lead to significant food packing anyway


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