Lecture given by professor burke in speke (july 2014)

I enjoyed the above lecture which will possibly be the last postgrad lecture that I will listen to prior to retirement. I have worked in the same practice since I qualified in 1977 so my successes and failures come back to visit me. Like Professor Burke, I have avoided amalgam for many years; I only use it to repair old amalgams and sometimes for a subgingival box where I am unable to ensure an adequate seal. I'm rather quiet and shy but it occurred to me, while I was listening to the lecture, that I should share my experience so that it could be considered as an option. I have only now realized that I may be the only dentist using this technique (Arrrgh!)

I largely stopped using matrix bands for posterior composites over 10 years ago when it dawned on me that you place composites rather than packing them like amalgam. I was using disposable matrix bands and found them awful so this motivated me to find an alternative method. I always wear loupes and they are essential for this technique. I carefully place a layer of composite at the base of the box and use a flat plastic to ensure that there is no ledge, then gently mould the composite out to touch the adjacent tooth. I cure it for 10 seconds, then proceed to build-up the filling incrementally; the walls of the cavity and the adjacent tooth acting as a matrix. If it is a virgin tooth, I try to avoid breaking the contacts palatally and buccally to keep the restoration as minimal as possible. If the contacts are already broken, I use my flat plastic to contour the filling there and use a fine tapered diamond to remove any excess, if needed.