Some confusion with a few viewers: "The point of bur entry is within the incisogingival dimension of the carious lesion or defective restoration and as close the the adjacent tooth as possible without contacting it. Direct the bur PERPENDICULAR (90 degrees) to the enamel surface..." Sturdevant, "The Art and Science of Operative Dentistry" Angling the bur at a 45 degree angle undermines the incisal enamel.
One more thing: For an MF (facial approach) the bur is initiated at a 45 degree angle and the facial enamel is left undermined, but this works because the facial surface isn't under function. This is done primarily for esthetic reasons.
Hi Dr. Stevenson, we were taught that gingival clearance needs to be .5mm since that’s what the CDCA requirements are. I’m not sure what the other licensures requirements are though. Also thank you for this video. It was truly helpful.
Hi Dr.Stevenson thank you for your great videos; could you please make a video of veneer composite techniques for colored teeth with no shell I mean direct composite veneer . Thank you❤️
AWESOME DEMONSTRATION! Thank you so much for sharing your knowledge! It's so helpful to us dental students What RPM did you set the electric motor while you did this demonstration without water?
It was done with an air driven handpick, but when we use electric I prep at full speed for the majority and then slow to 5,000 or sometimes less for refinement. Thank you
This is great video. Do you post videos for placing the restoration? 8 ML is an intricate fill. I do appreciate educational videos like this. I'm an EFDA student, and I do try to find as much as I can to help broaden my skill for this type for preparation. Thank you.
Thank you for all the great tutorials! Just curious if you'd be able to make a video on a class III DL prep on either #6 or #11? These specific preps are very challenging for me due to the morphology of the canines, especially because the distal contacts are so short on our Acadental typodonts.
Crisp and clear knowledge 👌 . I have 2 ques: 1. Which operator position would you suggest to prepare class 3 cavity on Distolingual surface of tooth no. 12 ( first quadrant lateral incisor)? I find it difficult to access this surface while keeping the bur perpendicular to tooth and using a hatchet to smooth the walls feels impossible. 2. I am currently using 3.5x magnification for restorative work required for the exam. Do you think i should switch to 4x or 4.5x to make my work more intricate for the examiner to check 😅 what according to you will be the sweetspot for magnification for a dental student?
1. Use the 11 O'Clock position but have the patient turn away from you - this help. 2. I siwtched from 2.5x to 4.5 x after two years and then 2 years after that ramped up to 6x. I also use a microscope. If you can, push the mag as high as you can - you'll quickly adapt. 4.5x isn't that high, so you should do well.
Hi Dr. Stevenson. Thank you so much for making these incredibly helpful videos. Your videos are an online school for many like myself who get inspiration from your work. Regarding restorative section of CDCA, the guidelines say that the examiners approve the diagnosis of the candidates before they can permit the candidates to proceed with the preparation. Can you please shed some light on the kind of diagnosis CDCA is expecting from candidates for the carious teeth? Thank you
Hello Dr. Stevenson Excellent demonstration! very informative and comprehensive Can I request you to demonstrate a Class 4 composite cavity preparation? Much appreciated!
Great content. You should do a full series of preparations. I think the summary of instruments and sequence is a really nice idea - so much choice and little direction out there.
Dear Dr. Stevenson, If the hand instrument provided (enamel hatchet) is of 1.5 mm, should the cavity still be at 1.5 mm size for DL on #9? Sometimes while practicing with a constraint of the provided hand instrument, I end up making the overall prep of 2mm. Could you please share how to keep it at just 1.5 mm and still be able to use that 1.5 mm hatchet? Thank you for this amazing video. Best regards, Adi
With a 1.5 mm hatchet this is very difficult - it will most always be at least 0.1 mm more than the width of the hatchet. Sometimes, you may wedge and create some separation and then it will fit easily...
There is this thing I am confused about. I was always taught to always use diamond burs to prep the enamel but I see a lot of US dentists to use those high speed carbide burs, whether it is crown prep and now a cavity. Could you please talk more about thee difference? Doesnt the bur have rather shattering effect?
In the early days of operative dentistry, carbide steel was the only technology known to make burs. It wasn't until much later, in the 1970's and 80's that diamonds really become commonplace in dental practices and textbooks. The more recent development of operative diamonds has taken some time to catch on, and although great for less chatter when penetrating enamel, they are relatively costly and not as precise dimensionally compared to carbides. If you were to peruse the two most significant Operative texts in the US - by Sturdevant and Summitt, you'll see that the carbide remains as the go to instrument for conservative preparations.
I want ask doctor about doing class 3 composite restoration in two caries crowded teeth when you have no any space intraproxmal between the teeth when you can't place TEFLON . And thanks doctor I benefited from your wonderful educational channel a lot
Bevels on the lingual of small class IIIs are no longer the standard taught in most dental schools. None of the national boards required them neither the WREB nor the ADEX. I have not been placing bevels for about 15 years. However when the class III preparation is large and extends onto the facial bevels are mandatory for retention and aesthetics.
Thank you so much,you are a great tutor I have question when we open contact in class 2 can we use interproximal bur or not? Can't we use inverted cone , enamel hatchet?
I would not use an inverted cone for composites due to the sharp line angles created with this bur. I'd use an enamel hatchet and be careful not to create a sharp internal line angle. Interproximal bur like a 169L, yes these are great. Thank you for the questions!
Hello Dr. Stevenson. Thank you so much for the video.. was very informative and helpful. My question is, I am supposed to do a class III restoration involving the labial, mesial and palatial walls. In this situation, do I start my prep from the palatial or labial surface? Any other particular points I need to keep in mind while making this preparation? Thank you in advance.
Im curious can this be done on the central incisors all across. I have a decay/tartar likely a cavity aswell it looks like a brownish line on the backside of my central incisors. I have no real tooth pain, feel irritation mostly but no sensitivity to hot or cold. Hopefully tomorrow I can go to my dentist and they can get a good look at it. I am praying a simple filling will fix my issue and not need to get a crown/root canal/ tooth extraction.
Yes, composite restorations may be a good option for you. If your problem is due to wear from grinding a night guard may also be suggested or even a sleep study - sleep disordered breathing and grinding are high correlated.
no need for class III's that are approached from the lingual and do not extend facially - lots of enamel exists for retention, and blend for esthetics is not critical on the lingual. Finally, the thin area of composite created by a bevel is more susceptible to fracture from occlusion...Bevels for class IVs are essential.
Hi Dr Stevenson, I have a question which might sound stupid. For all preparation of teeth ,from examiner point of view, what power loupes you recommend for practice? I got two loupes (3x and 6x) and my preparation seems very clumsy under 6x which seems fine and smooth under 3x. If we know what power loupes examiner will be using for marking, it'll be very helpful for students. Thanks...
Great question! Most dental school faculty and WREB/NERB examiners use 3.5x - 4.5x loupes. If the prep is smooth at 3.5x, it will always look less smooth at 6x. Using 6x takes many hours of practice and isn't initially practical. Do the best you can at 3.5x and you'll be in the "Green Zone" if you've met the criteria.
Hello doctor, thank you very much for your effort. Can you explain class 3for amalgam at distal of the canine? You are creative in explaining Your followers from Iraq🌷
Why is it that when viewed proximally, the facial wall is not parallel to the lingual surface of the tooth? Is it meant to be Parallel to the long axis of the tooth? Thank you!
The tooth is triangular as viewed from the proximal and the lingual wall and facial wall are converging, not parallel. The facial wall should attempt to parallel the facial wall. Thank you for the question!
Bevels are rarely employed anymore on class III's unless: 1. they extend onto the facial and require an esthetic blend, 2. The are large and require additional retention. The US licensing exams not only don't require them, but would prefer they not be beveled. When a bevel IS indicated, full enamel thickness, followed by an infinity bevel or starburst is great for facial surfaces.
@@StevensonDentalSolutions I see what your saying, I just used the 330 on my practical today and it did the trick for a very smooth surface with rounded internal line angles.
Most of us are migrating away from bevels when they don't add to the esthetics or significantly to the retention of the case. With class 3's which are prepped from the lingual, a bevel isn't helping enough to justify the additional enamel removal.
hi doc, which chair position would you suggest for preparing class 3 on mandibular canines both left and right , if we are only allowed to be between 9 - 12 o clock?
@@StevensonDentalSolutions it's a bit difficult to approach the canine in 3 quadrant , i will try turning the head so i could get to a comfortable hand position . Thankyou doc , knowing i have someone to reach to for help in problematic situations means alot 🙏
