Dr. Brady’s Top Clinical Tips

 Articles  1 Response »
Sep 092011
 

Dog Eared Sectional Matrix

Heraeus 360 Newsletter

June 2011

Lee Ann Brady DMD

I have the good fortune to interact with dentists from around the world. We discuss the practice of dentistry, share experiences, and trade little tips that we can take back to our practices. Some of these “tips” made such a difference in what I do, they have stayed with me, and I love to share them with others. Here are five of my favorites.

1)   Place a wedge interproximally as soon as the patient is numb, before beginning the prep. It can take several minutes for the PDL to be compressed and a wedge to overcome the dimension of the matrix band. This way you will see a space between the adjacent teeth, making prepping the box easier, and the contact tighter. You may have to place a larger wedge when you are ready to place the matrix.

2)   Don’t put your dentin adhesive out until you are ready to apply it. The solvent in dentin adhesive will evaporate; changing the thickness of the material and also altering it’s properties, such as bond strength.  If you are using a unit dose of I-bond don’t snap the cap until you are ready to apply.

3)   Dog Ear the corner of a sectional matrix to create a handle. Sectional matrix bands can be difficult to hold on to, and impossible to hold at the correct angle for placement. By bending down one corner, I create a handle that allows me not to contort my hand during placement.

4)   Use Gluma routinely. A good friend of mine has a standard line whenever anyone mentions Gluma, “Every Prep, Every Time”.  I am with him on this one, the near lack of post op sensitivity in my practice gives me peace of mind and it an incredible internal marketing tool.

5)   Take four photos on every hygiene patient that you print and give them for their records. One of the most powerful tools for increasing case acceptance I have implemented is to have my hygienist take a full smile, retracted smile, upper and lower occlusal photos. We take them at the beginning of the apt., print them and give the patient a copy for their records.  The hygienist instructs them that if they see anything in the photos they have a question about to circle it and then they will ask me when I come in.

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Creating Interproximal Contacts-Separation Ring Fatigue

 Dental Materials, Restorative Dentistry, Restorative Techniques  3 Responses »
Jul 192011
 

Garrison Ring ForcepsUntil today I hadn’t given any thought to the lifespan, care and maintenance of the separation rings that I use in the office to create tight interproximal contacts when placing a posterior composite restoration. The quality of the contact, however, is something I think about each and every day. Creating a contact that is tight enough and has the appropriate shape to prevent food impaction following restoration is a critical factor in success of the procedure. This last week I struggled through a patient appointment where we completed three class 3 restorations, the frustration came from trying to manage the matrix system and create those ideal contacts. This morning I went in search of an explanation for why I had so much trouble with the separation rings, for a system I have used and really loved for years. Continue reading »

Video: Full Contour Silicone Reduction Matrix

 Restorative Dentistry, Restorative Techniques, Videos  Comments Off
Jul 112011
 

Full Contour Lateral Silicone Reduction Matrix over canine preparation One of the challenges in restorative dentistry is ensuring adequate reduction for the technician to create an exquisite result, while remaining conservative in our preparation and not taking away more tooth structure then necessary. Accurate tooth preparation begins with utilizing the correct burs, knowing their dimensions, and creating depth cuts. Prior to taking final impressions in order to guarantee the correct reduction and avoid a call from the lab that necessitates bringing the patient back in, or compromising on the lab fabrication, reduction matrices are utilized for verification.

This video demonstrates the fabrication and use of a lateral full contour reduction matrix made from Flexitime Easy Putty.

Steps In fabrication:

Video: Fabricating a Silicone Incisal Reduction Guide

 Dental Materials, Restorative Dentistry, Restorative Techniques, Videos  Comments Off
Jul 052011
 
Silicone Incisal Reduction Guide made from Flexitime Easy Putty

Silicone Incisal Reduction Guide

This video demonstrates one technique for fabricating an incisal reduction guide. I use incisal reduction guides routinely in my practice both to verify the amount of reduction that I have created for veneers or crowns, as well as to layer incisal composite during a direct composite technique. In addition I use incisal guides on both the lower and upper arch during an equilibration to transfer the new incisal edge position from a work-up. This method will show how to cut the guide out of a full arch silicone matrix made from Flexitime Easy Putty, allowing the other half to be used to create a notebook Guide.

Fabrication Steps:

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 »

Placing A Sectional Matrix

 Dental Materials, Restorative Dentistry, Restorative Techniques  13 Responses »
Jun 142011
 

Sectional Matrix Band Bent on the corner to create a a handleI find it challenging to place sectional matrix bands, so much so that sometimes I just reach for a good old fashioned toffelmire, even though I know that adaptation and reproducing anatomic form is superior with the sectional. There are two pieces that frustrate me. The first one is how to hold on to those little pieces of metal, and secondly getting them in the right place and feeling like I have good control during placement.

I had the opportunity to watch my dental partner place a sectional matrix today, and it was eye opening. He reached for a pair of cotton pliers which are standard issue on our tray set-ups. He kept looking right past them, and then requested a pair of the straight tip cotton pliers. He explained that they grip better and make it easier to hold the sectional matrices, this was my first learning moment. Continue reading »