I admit that one thing I am picky about as a dentist is the cutting quality of a bur or diamond when I pick it up. I hate reaching over and seeing that there is “gunk” in the surface texture of the diamond, or worse using it and having to push it through the tooth because it is dull. With this in mind I thought I would check out the idea of single use diamonds. The concept behind single use diamonds is that you will never start a procedure with a dull bur.
My experience with things that are disposable has been varied. Often I find that the compromise in manufacturing to produce a cost-effective single use item, has reduced the quality. Single use diamonds are no exception. It is true that with single use diamonds no one has to be trained and regimented about cleaning them, they are always brand new. However, the cutting efficiency can be very variable due to the manufacturing process. Sometimes I am very pleased and other times I am reaching to change for another diamond very quickly. Regular multi-use diamonds are made following precision standards, and they are very consistent out of the package. The other challenge that I have is when I am preparing multiple teeth. A standard diamond should maintain it’s cutting efficiency for 8-10 preps. This is ideal when I am doing an upper anterior veneer case, or an entire quadrant of dentistry. In my experience, when they say single use, they mean it and the diamonds lose their cutting efficiency very quickly, so i can maybe get 1-2 preps.
Not having solved my dilemma, I called Brasseler so get their advice. I took away some very good learning from our phone call. The first thing I did was purchase a pumice stone for every operatory. My assistants have now incorporated running the diamonds in the pumice stone at the end of every procedure to clean out the “gunk” when they are breaking down the room. I also learned how devastating cold sterilization is on both diamonds and carbides, so our burs are bagged and autoclaved. Autoclaving and heat sterilization do contribute to the demise of our diamonds and burs, so we are getting much more efficient at only putting out the burs or bur blocks we need for each procedure, to reduce sterilizing burs that were never used.
I guess in the end, it really is a choice which way you go, single use or multi-use diamonds. Either way you will have to manage your inventory, and change burs chairside when you encounter one that doesn’t cut the way you want it to.
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