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

"Indirect Restorative Tooth Preparation: Extreme Efficiency and Accuracy”

Dr. Ian Shuman 

Tooth preparation for full coverage indirect restorations must be accomplished in a systematic, rapid, and atraumatic manner. For decades, diamond instruments have been the gold standard as the tool of choice in accomplishing these goals. Diamonds are safe, effective tools with a lower risk of potential iatrogenic tooth fracture than carbide burs used for the same purposes. Carbide burs have been used for gross reduction because diamond instrument surfaces fill easily with debris reducing cutting ability, or wore smooth and caused burnishing and overheating of the tooth surface. In response to this problem, a new design in diamonds has been created in the Piranha 2X Single-Patient-Use Diamond from SS White.

Crosscut bladelike channels increase cutting speed by chipping enamel and dentin away. These channel edges allow debris to be rapidly washed away from the surface of the cutting region, resulting in greatly diminished clogging. The new design has created more diamond exposure; by using medium grit diamond particles, greater cutting efficiency and extremely low heat generation is produced. Piranha 2X Diamonds simplify gross reduction for fast, clean preparation of enamel, existing restorations and caries removal. Because the Piranha 2X series is a single patient-use instrument, it offers affordability and increased patient satisfaction as a new bur is used for each patient and cross-contamination is no longer a concern.

Figure 1 A lower first molar with a failing composite restoration	Figure 2 Facial view of the same tooth	The Piranha 2X Diamonds are designed to rapidly reduce enamel and crown preparation time. Here an all too common clinical presentation of a failing composite restoration is shown. (Figs 1, 2) Following local anesthesia, 2.0mm occlusal depth grooves are made using the #856-020 Round End Taper Piranha 2X Diamond that has a corresponding diameter of 2.0mm. (Fig 3, 4) The depth grooves are joined and occlusal reduction is complete. (Fig 5) Depth grooves are made on the buccal (Fig 6) and lingual to a depth of approximately 1.5mm using the #854-018 Round End Taper Piranha 2X Diamond. An #878-016 Modified Bevel Cylinder Piranha 2X Diamond is used to complete reduction on the facial (Fig 7) and lingual followed by interproximal preparation and margin refinement. The preparation is complete and ready for the final impression. (Fig 8)
Figure 3 Depth grooves are made on the occlusal	Figure 4 A magnified view showing diamond design
Figure 5 The occlusal preparation is completed	Figure 6 Depth grooves are made on the facial (and lingual)
Figure 7 The facial aspect being prepared	Figure 8 The completed preparation

TABLE 1

• The Piranha 2X Single Patient-Use Diamond promotes infection control and patient satisfaction.
  

• Piranha 2X Diamonds sell at a fraction of the cost of expensive multi-use diamonds.

• The Piranha 2X Diamond has greater diamond coverage per surface area.
• More diamond exposure means faster cutting with lower heat generated.
• A new, sharp instrument for every patient maximizes cutting speed.
• Patented cross channels allow for maximum access for water coolant, thus keeping the preparation cooler than a standard multi-use diamond.
• The bladelike channel edges increase cutting speed by chipping enamel and dentin away.
• Cross channel design creates a cooling spray to efficiently dissipate heat buildup.

• Medium grit diamond particles insure a smooth margin finish.
• Friction is reduced as the amount of diamond in contact with the substrate at any given time is minimized with the cross channel design.