Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2018-02-22, 10:39:24 | version 1.38.0
4 RESTORATIVE Dental Tribune Middle East & Africa Edition | 2/2017 Balancing Efficiency and Esthetics – Maximizing Today’s Modern Materials By Dr. Cory Glenn, DDS, USA As many dentists in busy practices may know, being efficient during each procedure is a key to success on a day-to-day basis. I continu- ally strive to hone my skills to make procedures faster and better, and a large part of my ability to do this is my product mix. And although effi- ciency is extremely important to me, I won’t choose a set of products, even if they offer great efficiency, if the end result becomes compromised. A large part of my practice is per- forming direct posterior restora- tions, which can often become time consuming for me because of the need for multiple steps and multiple composite layers. Over the years I’ve been incrementally placing compos- ites with great results, but I wanted something easier for my posterior restorations. To make restorations simpler, I began researching new products marketing themselves as efficient and esthetic. I’m not the type to simply switch everything over to one new product without ample research and science backing up the product, so I began testing a select group of products I thought would work well. I began experimenting with a new adhesive, a new composite material, a new curing light, and a new finish- ing and polishing system. After the first few restorations I began achiev- ing great results quickly and easily. Characteristics of Adhesive Universal adhesives have been avail- able for several years and their goal is to be exactly what they say: uni- versal. In most cases, there’s no need for multiple bottles for different indications and most can be used in self-, selective-, and total-etch mode. After some initial research and talk- ing with colleagues I began trying Single Bond Universal Adhesive. In order to lessen the risk of using a new product, I began using it for a few procedures at first to gauge its performance and kept my old adhe- sive material on standby. Finding the Right Bulk Fill I’ve been intrigued with the advent of bulk fill composite in the last few years and their ability to be placed in one increment. But my experi- ences with these materials had been less than impressive in the past. Even though they were extremely efficient, I wasn’t comfortable using them. When I tested Filtek™ Bulk Fill Pos- terior Restorative, I saw many char- acteristics and results that I liked. A large concern I had with these com- posites was the amount of polymeri- zation stress that acts on the tooth, but research shows that Filtek Bulk Fill Posterior offers stress relief com- pared to many incremental fillings, which is great for my peace of mind. The esthetics of this material has also been pleasantly surprising to me. With Filtek Bulk Fill Posterior I can improve productivity and save valu- able chair time. It has excellent han- dling like the traditional Filtek mate- rials I use and is easy to shape. I now have several minutes left after a restoration where I can quickly look over case notes or take a short men- tal break before the next patient. It’s great not rushing from one restora- tion to another, and it really seems to create space in my day. The Importance of Proper Curing Not all curing lights are created equal. New LED models can produce higher light output and can cure materials more efficiently than previous types of lights while also making user op- eration easier. I’ve been experiment- ing with the Elipar™ DeepCure-S LED Curing Light and have found great success with it. It increases my confidence of a full cure at the bot- tom of the proximal box and has an ergonomic shape which makes operation easier by me or my assis- tants. With old and inefficient cur- ing lights, I would sometimes worry about achieving a reliable result and that’s not the case with this new cur- ing light. Simple Finishing and Polishing Finishing and polishing a restoration can mean the difference between a lifelike shine and a dull looking restoration. Switching between the traditional points, cups and discs, polishing can be tedious and time- consuming for me. I’ve been utiliz- ing the Sof-Lex™ Spiral Finishing and Polishing Wheels* and have seen great esthetic results. With this two wheel system, I simply run each wheel over the restoration to polish restorations quickly. I find it to be extremely quick, which in the end saves me time. Case Study The below case was completed with the products that I discussed above. When these products are used to- gether, they can create a truly effi- cient procedure for posterior resto- rations. The patient, a female in her mid- 50’s, presented with two leaking amalgam restorations on teeth #30 and #31. The patient desired a more esthetically pleasing composite res- toration and after examination, a bulk fill composite technique was deemed an appropriate treatment option. Step 1 The existing amalgam restorations (Fig. 1) are removed and caries dye is applied. When no additional caries are detected, the cavity preparation (Fig. 2) is sandblasted with aluminum oxide to ensure the preparation is free of all contaminants. surface scratches and the white pol- ishing wheel (Fig. 10) is used to create a high shine. The composite restora- tions are complete (Fig. 11). Figure 9 Figure 10 Figure 4 Figure 5 Step 3 As the preparation is less than 4mm deep, Filtek Bulk Fill Posterior Restor- ative is placed in one step (Fig. 6). A more detailed shaping and contour- ing of the composite is then done with a metal instrument (Fig. 7). The composite is then light cured for 20 seconds (Fig. 8). Figure 1 Figure 2 Step 2 The preparations are selectively etched (Figs. 3) with Scotchbond™ Universal Etchant Gel and Single Bond Universal Adhesive is rubbed into the surface for 20 seconds (Fig. 4). The adhesive is then gently air dried for 5 seconds (until the adhe- sive doesn’t move) to evaporate the solvents, and it’s light cured for 10 seconds (Fig. 5). Figure 6 Figure 7 Figure 8 Step 4 After adjustment using a finishing bur, the final polishing is completed with the Sof-Lex Spiral Finishing and Polishing Wheels. The beige finishing wheel (Fig. 9) is used first to remove Figure 3 Figure 11 Final Thoughts The newfound efficiency I’ve discov- ered for my posterior restorations has provided me several benefits. For instance, my restorations are quick- er, they require fewer products, and there are fewer steps needed. This all adds up to less stress for me during each procedure and in my day-to- day practice. For more information on the Efficient Restoration Procedure, visit 3M.com/EfficientRestorations Dr. Cory Glenn Dr. Glenn graduated from University of Ten- nessee Health Science Center College of Den- tistry. Following grad- uation, he went on to complete the Lutheran Medical Center’s advanced education in general dentistry residency at the UT Memphis branch. He is a graduate of the Georgia Maxi Course in Implant Dentistry, and is an Associate Fellow in the American Academy of Im- plant Dentistry. Dr. Glenn operates a pri- vate practice in Winchester, TN where he performs all disciplines of dentistry with a particular focus on utilizing technology and innovative techniques. *Replaced with the new Sof-Lex™ Diamond Polishing system consisting of two new wheels - pre-polishing spiral (beige) and diamond-impregnated polishing spiral (pink) in 2016. 3M Oral Care Solutions at AEEDC, 2017 By 3M On 7-9 February 2017 3M Oral Care took part in AEEDC, one of the largest regional trade shows for oral care pro- fessionals in the MEA Region. During the 3 days of AEEDC exhibition 3M Booth was attended by visitors from various countries across the Region and get familiar with vast procedure solutions for greater clinical, profes- sional and personal success. In the Direct Restorative Procedure area dentists could learn more about Esthetic Procedure Solution with Fil- tek™ Z350XT Universal restorative, Single Bond Universal adhesive, new Elipar™ DeepCure curing light and Sof-Lex™ Diamond Polishing system allowing to create beautiful, natural- looking restorations having diamond paste-like gloss. Or to try Efficient Procedure Solution with Filtek™ Bulk Fill Posterior restorative designed to improve productivity by enabling fast and easy posterior restorations. The Indirect Procedure area was dedicated to the sub-procedure so- lutions, such as impressioning with Impregum™ and Express™ Penta™ materials, cementation with RelyX™ U200 composite cement and tempo- rization with Protemp™ 4 material which all together enable less com- plicated process, fewer missteps, and therefore more productive and prof- itable procedure. In the Orthodontic Procedure area doctors had an opportunity to learn more about the Esthetic Procedure with Clarity™ Advanced ceramic brackets and Efficient Procedure with Metal brackets complemented with APC™ Flash-Free adhesive coated ap- pliance system which allow growing orthodontic practice with esthetics and efficiency. The Education area of the booth equipped for short lectures and de- mo-sessions attracted a lot of doctors who could to learn about such proce- dures as esthetic composite restora- tions using Style Italiano technique, posterior restorations with Filetk™ 3M booth at AEEDC 2017 Bulk Fill Posterior restorative, preci- sion impressions and reliable cemen- tation techniques. To learn more about 3M Oral Care products please visit: www.3mgulf.com/espe