Silicone Bite Registration Material

 Dental Materials, Restorative Dentistry, Restorative Techniques  1 Response »
Jun 302011
 

Silicone Bite material applied to the maxillary teeth after drying.

Silicone bite registration material has become a standard in today’s practice. So much so, that we consider the use of wax very old school. With the advent of this new material, came some new challenges. Silicone and saliva do not mix. It can be difficult for us and uncomfortable for the patient when the material is sliding off the teeth and down the throat as it is being injected. Another challenge is keeping the patient from wiping the material off of the teeth with their tongue, or pushing it tot he buccal. I have learned some very simple tips that make using silicone bite registration material quick, efficient and very predictable.

First make sure that the teeth have been adequately dried before injecting this material. If the teeth are moist with saliva the silicone will run off the teeth and often slides right into the back of the mouth. In our office we do this either by blowing air with the air water syringe tip, or by having the patient bite on a tissue that has been folded and placed in a miller forcep. Continue reading »

Warming Mirrors for Dental Photography

 Dental Photography  7 Responses »
Jun 292011
 

Buccal mirror in place for a buccal retracted dental photographTaking dental photographs in mirrors can be challenging enough, without having to worry about controlling the fog. Over the years I have tried and abandoned many techniques for warming the mirrors so that they don’t fog during photographs. The first technique I tried was placing the mirrors in a bowl of hot water. It warms them for sure, but I ran into several challenges. First getting water that is hot enough, then carrying it to the room without spilling it or tipping over the bowl once it was in the room. If this all worked, the last problem, was that once warmed the mirrors are wet and have to be dried prior to use. Since you don’t want to rub dental photography mirrors with paper towels or anything course, this required having sterile chamois in the room.

I abandoned this technique and tried warming the mirrors with a torch, using the same waving technique for warming wax for bite records. My challenge with this was getting the mirror evenly heated, not too cool which means it still fogs and not too warm or it burns the patient. I also found patients got a little skeptical watching all of this. When I finally burned my own fingers I gave up. Continue reading »

Loading Temporary Dental Cement

 Dental Materials, Restorative Dentistry, Restorative Techniques  Comments Off
Jun 282011
 

I am always amazed by the variety of techniques and preferences that dentists have for how an assistant loads temporary cement into a restoration. You only have to ask an assistant who works in a multi-dentist practice to hear the variations. I have seen assistants load the provisional directly from the tip of the new systems that mix and dispense. Others dispense the temporary cement on to a mixing pad. Once it is on the mixing pad, there are many ways to load the provisional. Lastly, many of the temporary cements still require mixing, so will arbitrarily be on a pad before being loaded in the temporary. Continue reading »

Video: Fabricating a Silicone Model from Mach II

 Dental Materials, Restorative Dentistry, Restorative Techniques, Videos  5 Responses »
Jun 272011
 
Silicone model made from Mach II and bite registration

Silicone Model

This video demonstrates fabrication of a silicone model, made from Mach II die silicone and bite registration material. This type of silicone model is a daily occurrence in my practice as I use them for fabrication of anterior bite plane appliances, indirect provisionals, and any other time I need a quick way to get a highly accurate model.

 

Fabrication Steps:

Full Face Photo in Dentistry-Why?

 Dental Photography  Comments Off
Jun 242011
 
Full Face Pre Operative Dental Photo

Pre-Op

Full face photos can be uncomfortable and awkward for the patient, both to take and to look at, but they are a vital part of my series of dental images. Very often when doing a consult with a patient I will not have the full face in the presentation, because for everyone, looking at a photo of yourself can be uncomfortable and distracting and at a minimum people get busy evaluating themselves.

So why do I take them routinely? Continue reading »

Using a Leaf Gauge to Adjust an Occlusal Appliance

 Occlusion/TMD  4 Responses »
Jun 232011
 

Leaf Gauge being used to find first point of contact.

One of the goals of an occlusal appliance can be to release the Lateral Pterygoid muscles, seat the condyles in Centric relation and establish intercuspal position at this point. Over the years I have varied my technique for reaching this goal. One approach is to use bimanual guidance ( bilateral manipulation) each time you mark the posterior occlusion until you have achieved multiple stable stops. At this point most patients can close on their own repeatedly into this position to allow completion of the adjustment. Another approach is to adjust the appliance overtime, getting stable stops and allowing the appliance itself to release the muscles. This method requires seeing the patient at short intervals so that each time they develop a new posterior interference you readjust giving them multiple stable stops. Continue reading »

Quadrant Dental Impressions with an Isolite

 Restorative Dentistry, Restorative Techniques  2 Responses »
Jun 222011
 
Quadrant Impression with Isolite

Quadrant Impression with Isolite

I had a patient in today to complete crown preparations and take final records for a full lower quadrant. I completed my preps on both lower molars and the second bicuspid, placed my retraction cord and was ready for the impression. At the beginning of the appointment we had taken a full upper impression for our opposing and a facebow. Using full arch models and mounting them on an articulator will allow the lab to return restorations to me with both the MIP and the excursive  movements adjusted in and I will have minimal work to do to finalize the occlusion during the seat appointment.

With this in mind we had all the materials set out to take our impression. I was about to remove the Isolite, when I stopped and wondered about taking the impression with it in. I have had several occasions in the last few months when attempting to get good flash beyond the margins of multiple preps that I have not gotten everything in the first impression.  Continue reading »

Creating Value for a Comprehensive Dental Exam

 Practice of Dentistry  9 Responses »
Jun 212011
 

 

New Patient Interview

New Patient Interview

New patients join our office for a variety of reasons, and like most offices the most common request we get is to come in for a prophy. One of the things that I do many times a day is invite patients to have a comprehensive exam and create value for that process in their minds. In the last week or so I have been looking at  how I do this, asking myself the question of how I could be more effective. My process has evolved over the years and is a blend of many things I have learned in courses and through the process of implementation.

Meeting every new patient begins with a conversation, whether they are on my schedule or the hygienist. I open by asking them what brought them to our office and how we can be of service. My goals in this first few minutes is to have the patient do most of the talking, listen and learn about them, and use key questions to frame the conversation around dentistry. I ask them to share what it would be important for me to know about their general health, and their dental health. This is my adaptation of a process called “Staying in The Question”, which I learned from my good friend Mary Osborne. Continue reading »

Fabricating a Matrix with Silicone Lab Putty

 Dental Materials, Restorative Dentistry, Restorative Techniques, Videos  Comments Off
Jun 202011
 

This video demonstrates the process of fabricating a matrix using silicone lab putty on a dental cast. These matrices can be used to create reduction guides or provisional matrices used during a restorative procedure.

Fabrication Steps:

  1. Measure out the base and catalyst precisely.
  2. Mix the base and catalyst thoroughly until a uniform color has been achieved. Continue reading »

Dental Impressions for Patients with Lingual Tori

 Occlusion/TMD, Restorative Dentistry, Restorative Techniques  2 Responses »
Jun 172011
 

Lower Model of Patient with Lingual ToriToday in the office I had a new patient with lingual tori that almost touched at the midline. She was in the office for a TMD evaluation, our recommendation was to begin with a bite appliance. This left us with the challenge of how to get good quality impressions. My assistant was pulling out an assortment of trays, plastic and rim lock, to try and figure out what would work when I remembered a trick I hadn’t done in years. I reached over for a stock plastic tray, an upper tray. I asked the patient to lift her tongue to the roof of her mouth and began trying in the upper tray, over her lower teeth. I opened up the area that would be the palate so she could comfortably have her tongue out of the way. Once we had this adjustment made I used rope wax to cover the edge I had adjusted. I have not found a better way to correct for the sharp edge of plastic when you take an acrylic bur to the tray. Continue reading »

 Older Entries