"Check your protocol in the most difficult conditions"
.... Lower second molar with deep mesial and distal caries, full cusp coverage needed, financial limitations... all that issues means that instead of doing indirect work we have to go with some direct approach.
What options do we have ? We can make direct overlay filling with flat anatomy that is quite good solution or because we are young and ambitious dentist we can go with some fancy anatomy ( what is difficult when we don't have any referential points ) and then make a flat surface during occlusal adjustments.
...but maybe lets try sth different...
COPY & PASTE direct overlay... it is not easy at all but with some training it begins to be predictable and interesting alternative for other solutions.
Advantages of that technique :
- you have perfect occlusal anatomy from the very beginning
- at the end of the visit your filling is perfect in occlusion
- comparing to indirect overlay there is no problem with cementation and there is no any connection between DME and onlay
- you can create contact point as you want using Matrix Selection System
- single visit
Disadvatages :
- time consuming at the beginning
- onlay try-in in posterior area can be difficult
- limitations in the final onlay anatomy
This case was really difficult.
Isolation was a nightmare from the very beginning because I had to put a clamp on the wisdom tooth deep below the gum level. ( I was doing that for about 20 min and used 3 sheets of Nictone and tried 3 different clamps )
Then deep, almost to the bone mesial caries. I removed the gum with cylindrical GingiBur...
Full description of the procedure you will find below pictures.
Till now I made about 10 similar cases and I see more benefits than disadvantages.
If you find it useful leave a comment please.
Cheers
"Check your protocol in the most difficult conditions"
.... Lower second molar with deep mesial and distal caries, full cusp coverage needed, financial limitations... all that issues means that instead of doing indirect work we have to go with some direct approach.
What options do we have ? We can make direct overlay filling with flat anatomy that is quite good solution or because we are young and ambitious dentist we can go with some fancy anatomy ( what is difficult when we don't have any referential points ) and then make a flat surface during occlusal adjustments.
...but maybe lets try sth different...
COPY & PASTE direct overlay... it is not easy at all but with some training it begins to be predictable and interesting alternative for other solutions.
Advantages of that technique :
- you have perfect occlusal anatomy from the very beginning
- at the end of the visit your filling is perfect in occlusion
- comparing to indirect overlay there is no problem with cementation and there is no any connection between DME and onlay
- you can create contact point as you want using Matrix Selection System
- single visit
Disadvatages :
- time consuming at the beginning
- onlay try-in in posterior area can be difficult
- limitations in the final onlay anatomy
This case was really difficult.
Isolation was a nightmare from the very beginning because I had to put a clamp on the wisdom tooth deep below the gum level. ( I was doing that for about 20 min and used 3 sheets of Nictone and tried 3 different clamps )
Then deep, almost to the bone mesial caries. I removed the gum with cylindrical GingiBur...
Full description of the procedure you will find below pictures.
Till now I made about 10 similar cases and I see more benefits than disadvantages.
If you find it useful leave a comment please.
Cheers
Please rate this case
Initial......initial onlay preparation... just make a deep grooves......rough onlay preparation......ready onlay try-in...and occlusion check.....then normal Success Stairs protocol ... pre-isolation S.T.A.R sequence...caries...caries....caries......Safe preparation with M.A.CTeflonNapkin & TeflonIsolation...and this is why I love teflon......onlay ready to prepare...
"Check your protocol in the most difficult conditions"
.... Lower second molar with deep mesial and distal caries, full cusp coverage needed, financial limitations... all that issues means that instead of doing indirect work we have to go with some direct approach.
What options do we have ? We can make direct overlay filling with flat anatomy that is quite good solution or because we are young and ambitious dentist we can go with some fancy anatomy ( what is difficult when we don't have any referential points ) and then make a flat surface during occlusal adjustments.
...but maybe lets try sth different...
COPY & PASTE direct overlay... it is not easy at all but with some training it begins to be predictable and interesting alternative for other solutions.
Advantages of that technique :
- you have perfect occlusal anatomy from the very beginning
- at the end of the visit your filling is perfect in occlusion
- comparing to indirect overlay there is no problem with cementation and there is no any connection between DME and onlay
- you can create contact point as you want using Matrix Selection System
- single visit
Disadvatages :
- time consuming at the beginning
- onlay try-in in posterior area can be difficult
- limitations in the final onlay anatomy
This case was really difficult.
Isolation was a nightmare from the very beginning because I had to put a clamp on the wisdom tooth deep below the gum level. ( I was doing that for about 20 min and used 3 sheets of Nictone and tried 3 different clamps )
Then deep, almost to the bone mesial caries. I removed the gum with cylindrical GingiBur...
Full description of the procedure you will find below pictures.
Till now I made about 10 similar cases and I see more benefits than disadvantages.
If you find it useful leave a comment please.
Cheers
"Check your protocol in the most difficult conditions"
.... Lower second molar with deep mesial and distal caries, full cusp coverage needed, financial limitations... all that issues means that instead of doing indirect work we have to go with some direct approach.
What options do we have ? We can make direct overlay filling with flat anatomy that is quite good solution or because we are young and ambitious dentist we can go with some fancy anatomy ( what is difficult when we don't have any referential points ) and then make a flat surface during occlusal adjustments.
...but maybe lets try sth different...
COPY & PASTE direct overlay... it is not easy at all but with some training it begins to be predictable and interesting alternative for other solutions.
Advantages of that technique :
- you have perfect occlusal anatomy from the very beginning
- at the end of the visit your filling is perfect in occlusion
- comparing to indirect overlay there is no problem with cementation and there is no any connection between DME and onlay
- you can create contact point as you want using Matrix Selection System
- single visit
Disadvatages :
- time consuming at the beginning
- onlay try-in in posterior area can be difficult
- limitations in the final onlay anatomy
This case was really difficult.
Isolation was a nightmare from the very beginning because I had to put a clamp on the wisdom tooth deep below the gum level. ( I was doing that for about 20 min and used 3 sheets of Nictone and tried 3 different clamps )
Then deep, almost to the bone mesial caries. I removed the gum with cylindrical GingiBur...
Full description of the procedure you will find below pictures.
Till now I made about 10 similar cases and I see more benefits than disadvantages.
If you find it useful leave a comment please.
Cheers
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