Dentaltown April 2018 - 44

message board
mopsy
Member Since: 11/22/02
Post: 18 of 176

Is it sensitivity on flossing or chewing? Often, flossing means that you have a bond failure at
the margin, while biting is due to composite pulling away from the prep. Could be overheated
pulp from dull burs.
Check your curing light to make sure that it's working properly. If you are using an air/water
syringe, make sure that there is no water coming out. I am in the habit of blowing a few times
on the patient's bib to blow out any water left in the tip before I dry the tooth.
Isodry. Etch on enamel only. SE Clearfil Protect, follow the steps and air-dry to evaporate
solvent. Cure. Place a small amount of resin in the box and on the pulpal floor. I use explorer
to gently drag flowable around to make sure that it's well adapted to the corners, undercuts and
rough prep areas. Cure flowable. Pack resin in small increments. I like packing against the walls
at an angle, instead of packing straight down. I also cure from lingual and buccal once I remove
the sectional matrix. Dry the tooth before checking the bite. Sometimes, it helps to put a little
Vaseline on articulating paper.
Good luck! I think we've all had a sensitive composite streak until we figured out how it
1/22/2018
works best in our hands. ■

tooth college

Look up Surpass from Apex Dental. Lots of threads on it here on Dentaltown. ■

Member Since: 05/06/07
Post: 21 of 176

davidpalmer
Member Since: 04/14/00
Post: 25 of 176

1/22/2018

This is a common problem with posterior composites, it's a C-factor problem. It's terribly
frustrating but with an easy solution. If you want to make your life easier and quit losing patients
because of postop pain, just do a couple of things:
1. After etch and rinse/dry, use Brush & Bond.
2. Use a dual-cure composite like HyperFil from Parkell and let it self-cure for a few minutes
before hitting it with the light and finishing.
That's it. Nothing more. Your problems will disappear like magic. There was a recent dental
article on this confirming what I had to figure out on my own. It works! ■
1/23/2018

eeznogood
Member Since: 02/23/06
Post: 26 of 176

All different answers. Tells you how many possibilities there are to explain postop sensitivity
after a simple restorative procedure! OP: Tell us which bonding system you are using and we
could be able to help you more precisely. Depending on the brand or the generation, advice can
be radically different. ■
1/23/2018

davidpalmer
Member Since: 04/14/00
Post: 29 of 176

Not sure if OP does amalgam but if overheating was the problem, amalgams would also be
affected. This is a common problem with a simple answer. ■
1/23/2018

eeznogood
Member Since: 02/23/06
Post: 37 of 176

44

James, you are using a single-bottle system.
Based on your description of your protocol, your most common potential culprits:
1. Applying two to three coats of bonding agent before curing, not just one coat, and mixing
it with your brush before applying. Very important.
2. After evaporating the solvent properly, which you say you corrected, then cure for 10
seconds, not 5 to 10. You risk undercuring the bonding. Deadly.
3. If the bottle is several weeks old, the solvent could be all gone, rendering it useless. Usually,
after a couple of months change the bottle.

APRIL 2018 // dentaltown.com


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