Dentaltown September 2019 - 34

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portion first will give better access and visibility as well. Then axial reduction, then old restorative materials. Remove any decay and refine the internal walls, break the gingival contacts ...
pack cord, refine margin where needed. Ultradent ViscoStat is a great tissue management agent
for bleeding, or use laser, check for undercuts, soak the cord in ViscoStat before you pack the
cord, or use Comprecap or Traxodent. You can use a carbide 557 to cut short the shank of your
diamond burs so you have more access for the distal of second molars. I usually like to make
the temp before impression to know if I have enough reduction and any undercuts ... and how
retentive my prep is. ■
6/5/2019

velogeek
Member Since: 04/15/10
Post: 19 of 181

Developing a sequence and sticking to it is critical to your goal. The first and the most
important part is that you recognize your approach needs refinement. If I may be so bold,
when I look at your prep and the diamond marks, it appears you are trying to use one bur to go
circumferentially around the entire tooth and then come back with a different one.
You commented on the finish line, now as you get faster you will rarely pick a diamond more
than once, so what I'm going to suggest is contrary to that. You might find it easier to prep each
part of the tooth separately. Prep the buccal, then the lingual, then the interproximals, focusing
on creating a continuous depth margin and a smooth one. Then connect all your finish lines. In
this way you can focus on each part of the tooth and not constantly have to move your mirror,
head or patient. I find when I do move around too much my preps suffer, because you usually
have to stop the handpiece as well and it moves, and you have to find where you left off. ■
6/5/2019

randy9798
Member Since: 12/06/17
Post: 22 of 181

Round diamonds are great for creating buccal and lingual margins. Then you only need to
connect buccal and lingual margins. Use two hands when possible. There are also end-cutting
diamonds for polishing margins. Most important is creating a system that works for you and
trying to be consistent. Wish you the best in your journey toward excellence! ■
6/6/2019

frumpy creepsmile
Member Since: 07/02/09
Post: 23 of 181

I think you are trying to tackle too many things at once. Very few people can do gross
reduction, margin placement and taper all in one shot. Break it up into different steps, and use
burs that will compensate for your tendencies. (I tend to produce almost completely vertical
walls, so I need to consciously add taper.)
I call it "erasing the margin" because the torpedo bur leaves an equi-gingival bevel margin. I
remove that lip as I drop into the sulcus and produce a knife-edge margin.
Chamfer margins are not as easy to produce as people make it sound. There is an extremely
high error rate (as you, as an aware clinician, are noticing). Controlling all of the parameters necessary to leave a smooth, flowing, uniform margin is difficult. Auditing dies in a lab is eye-opening. ■
6/6/2019

midila
Member Since: 04/10/18
Post: 34 of 181

I personally like to reduce the tooth in this specific order: occlusal, buccal, lingual, interproximal. By the time I get to interproximal, the area is thin enough that you should be able to
fly through the contacts with a diamond. Everyone here has definitely provided awesome tips. I
think keeping to a few dedicated burs is key here, as others have mentioned. ■
6/6/2019

jakewolf
Member Since: 02/28/14
Post: 36 and 39 of 181

That prep reminds me of when new assistants try to make a temp with the high-speed and
a skinny bur. I always sit down and show them how I do it with a straight-nose cone and an

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Dentaltown September 2019

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