Clinical Corner: Information on Dental Procedures

Articles

What's Hot: Dr. Glazer on Jazz
Combating Hidden Decay with Early Detection
Atraumatic Removal of Defective Crowns
Balancing: The Art, Science and Business of Dentistry
Intra-Oral Preparation of Titanium Abutments in Order to Obtain Ideal Angulations and Contours
SS White Express Line High Speed Laboratory Metal Finishing Burs
Direct Preparation Of Preexisting Implant Abutments For Case Rehabilitation
Flextime Xtreme: The 80/20 Rule
Fast and Smooth - Efficient Crown Preparation With Carbide Instruments
When Advancing the Bur, One Can Feel the Presence of Dentinal Caries
Precision Trimming and Finishing of Current Dental Restorations Using the Safe End Bur System
Indirect Restorative Tooth Preparation: Extreme Efficiency and Accuracy
Creating Maximum Efficiency and Accuracy In Indirect Restorative Tooth Preparation
Preparation Protocol To Ensure Predictable Aesthetic Restorations
Tooth Preparation Mastering Quality and Efficiency
Fissurotomy: Proactive Treatment for Incipient Decay
Anatomically Adapted Carbide Finishing Burs - Creating Super-Smooth Composite Surfaces in Two Steps
Directions for Use: Dr. David Clark Kit
Placing Traditional Sealants with Enhanced Magnification: Methodology to Increase Both Short-term and Long-term Success - David Clark, DDS
How to Quickly and Conservatively Restore a Natural Shine after Orthodontic Bracket Removal
SS White Surgical Length Oral Surgery Burs: Atraumatic Removal of Teeth for Maximum Bone Preservation

"Directions for Use: Dr. David Clark Kit"

David Clark, D.D.S.

Following is a summarized breakdown of the different SS White diamond and carbide burs that are contained within the Dr. David Clark. This kit is currently being used for all of Dr. Clark’s hands-on courses. There is a corresponding photo of each of the burs from the kit.

Instrument #1 Piranha Diamond #856-018C

Instrument #2 Piranha Diamond #856-012SC

Instrument #3 Piranha Diamond #862-012SC

Instrument #1(Piranha Diamond #856-018C)
This diamond has a standard 3.5-degree taper for full crown preparations and is ideal for use when preparing multiple teeth. This diamond has become my workhorse because of its overall size and diameter. This diamond is used with a “light lateral brushing movement” for delicate axial reduction. As described in my course, I do not create a chamfer for the full width of this bur. You will not be able to rest it vertically on a standard shoulder margin if you are attempting to create the delicate .5mm axiogingival reduction, like we cut in the course. For single unit preparations, I will use this bur on the facial and lingual surfaces because it is a little easier to control and manage than the smaller instrument #2 diamond (Piranha Diamond #856-012SC). For a single tooth full porcelain crown, this diamond is too wide and removes excessive tooth structure in the interproximal areas.

Instrument #1 is the bur I use for depth cuts on the incisal and occlusal surfaces as well as for the majority of the shaping for veneer preparations. This diamond will also cut the palatal and onlay “offset” (or “trench” as some of you preferred to call it).

Instrument #2 (Piranha Diamond #856-012SC)
This diamond is ideal for the interproximal of single full porcelain crowns because of its much thinner shape than instrument #1. Practice makes perfect, it takes a little time to get used to cutting a margin with such a small tip, but the resulting benefits make the added effort well worth it. Because of the minimal reduction, heat generation is not passed through to the pulp. The pulp will thank you.

Instrument #3 (Piranha Diamond #862-012SC)
This is a flame shaped supercoarse diamond. Instrument #3 is excellent for back-to-back Clark Class II preparations as you can cut both preparations at once. The tip is robust to allow clinicians to chase after small dentinal caries. For reasonably sized back-to-back class II preparations, it is the only instrument in most cases that I need start to finish.

Instrument #4 Piranha Diamond #858-014F

Instrument #5 Piranha Diamond #368-023C

Instrument #6 Piranha Diamond #368-023F

Instrument #4 (Piranha Diamond #858-014F)
This is a fine finishing diamond with a small round tip. This diamond is good for finishing composite restorations as well as polishing occlusal grooves within the composite restoration.

Instrument #5 (Piranha Diamond #368-023C)
This is an important diamond and is used for “saucerization” on the lingual of incisors and canines for full porcelain crowns. As we discuss in our courses, this is one of the few areas where we see under-reduced teeth in full coverage crowns.

Instrument #6 (Piranha Diamond #368-023F)
This is the fine grit version of instrument #5. This diamond is nice for composite finishing.

Instrument #7 SS White #7404

Instrument #8 SS White #7664

Instrument #9 Original Fissurotomy Bur

Instrument #7 (SS White #7404)
This is a 12-blade carbide finishing bur. The shape and size of this bur makes it nice for carving and finishing occlusal anatomy in posterior composites.

Instrument #8 (SS White #7664)
This is an absolute perfect 12-blade carbide bur that is used for polishing the enamel of the palatal and onlay offset. This finishing bur will create a beautiful surface that keeps crisp, sharp veneer and onlay enamel margins from chipping.

Instrument #9 (Original Fissurotomy Bur)
The Original Fissurotomy Bur is a very important bur in my practice. This bur is used to clean and explore the grooves of molars for minimally traumatic posterior composite restoration placement (super-sealants).

The Original Fissurotomy Bur is used to penetrate the enamel in a Class II preparation when restoring a single tooth. The end of the OriginaI Fissurotomy Bur cuts exceptionally well. The final “serpentine” (or gold inlay type flaring at the margins) shape is best created with a fine diamond such as instrument #4. There must be at least a half-millimeter of clearance with the neighboring tooth in order to use the Bioclear System and to create the ideal cavity shape.

Instrument #10 Fissurotomy NTF

Instrument #11 Great White #2 Bur

Instrument #12 Great White Ultra #856-016

Instrument #10 (Fissurotomy NTF)
The Fissurotomy NTF is similar to the Original Fissurotomy Bur but is narrower. This bur is use in bicuspids or to chase the deeper areas of staining in the grooves in molars. The tip is incredibly small and is used in our course for the mammelon groove depth cuts in laminate preparations where we only want .1 to .2 mm depth.

Instrument #11 (Great White #2 Bur)
The Great White #2 carbide bur by SS White is a fabulous restoration removal bur. It is a highly dentated round-ended carbide bur that also works exceptional well when used to create endodontic access. The Great White #2 bur will cut through both metal as well as porcelain when removing old restorations. The Great White #2 cuts smooth enough that the porcelain rarely fractures. Use a new bur for porcelain that you want to keep. Cutting through a nice porcelain crown that we wish to save is always a little nerve racking.

Instrument #12 (Great White Ultra #856-016)
The Great White Ultra Bur is an absolute “Rock Star” when used in an electric handpiece to cut through old junk; for example to disassemble old porcelain and metal. It will not break, stall or catch like a standard #557 bur.