Dentaltown November 2017 - 48

message board

Whose Problems Are We Solving?
Ours or the Patients?
An honest discussion about occlusal composites. Is there a new trend that focuses too much
attention to aesthetics and not enough on achieving proper occlusion? Where's the balance?

RubinsteinDDS
Member Since: 08/15/07
Post: 1 and 5 of 64

[Editor's note: View this message board online to view a video in this post.]
Every time I see technique like this I am both impressed and confused. Impressed with the
care and attention to detail, confused by the reasons for the compromises being made. An upper
molar occlusal will pretty much never be seen by anyone except a dentist, an anesthesiologist or a
medical examiner. This type of technique is guaranteed to include voids and air bubbles into the
restoration. It is also going to take longer. I pay attention to isolation, caries removal, a smooth,
clean prep, and excellent primary anatomy built in a few layers as I can be sure will cure properly.
I get that we dentists love seeing perfected occlusal staining and anatomy, but what is this
doing for the patient? To repeat, though, the technique is super impressive (except maybe the
lack of a rubber dam). I'm impressed every time I see this. But would a patient look at this and
say "thanks...but can you get rid of the brown stains please?"
To me, the most important thing is getting proper occlusion, proper transitions from tooth
to restoration, and proper basic form. Everything else ... I just don't see it, except to impress other
dentists. I'm not a "bulk fill" guy either. That goes too far in my opinion. But the fewer steps and
the fewer increments the better. ■
7/31/2017

Spring Daffodils
Member Since: 07/26/16
Post: 6 of 64

And I'm curious to know what the patient's next dentist will think about those stains and
whether he/she will remove that beauty of a composite and replace it. ■
7/31/2017

windmill
Member Since: 05/01/03
Post: 7 of 64

And will the patient ever look at a "stained" composite and think, "He made it look like it
has a cavity."... if they can see it. ■
7/31/2017

mkfdds
Member Since: 12/10/10
Post: 9 of 64

Tom Mitchell
Member Since: 02/16/04
Post: 11 of 64

48

And the next DDS to see the patient will think it is decay and drill it out. ■
7/31/2017

OK here you go. Done really fast (the speed most of us need to work at) with really great
materials:
This is #19 after the prep (broken amalgam) and Surpass 1,2,3 and Titan Flowable WO
co-cured with Valo on XTRA POWER (plasma setting) for three secs.

NOVEMBER 2017 // dentaltown.com


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Table of Contents for the Digital Edition of Dentaltown November 2017

Dentaltown November 2017 - Intro
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Dentaltown November 2017 - Cover3
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