Dental Tribune U.S. Edition

COSMETIC TRIBUNE The World’s Dental Newspaper · US Edition Publisher & Chairman Torsten Oemus t.oemus@dental-tribune.com Chief Operating Officer Eric Seid e.seid@dental-tribune.com Group Editor & Designer Robin Goodman r.goodman@dental-tribune.com Editor in Chief Cosmetic Tribune Dr. Lorin Berland d.berland@dental-tribune.com Managing Editor/Designer Implant, Endo & Lab Tribunes Sierra Rendon s.rendon@dental-tribune.com Managing Editor/Designer Ortho Tribune & Show Dailies Kristine Colker k.colker@dental-tribune.com Online Editor Fred Michmershuizen f.michmershuizen@dental-tribune.com Account Manager Mark Eisen m.eisen@dental-tribune.com Marketing Manager Anna Wlodarczyk a.wlodarczyk@dental-tribune.com Sales & Marketing Assistant Lorrie Young l.young@dental-tribune.com C.E. Manager Julia E. Wehkamp j.wehkamp@dental-tribune.com C.E. International Sales Manager Christiane Ferret c.ferret@dtstudyclub.com Dental Tribune America, LLC 116 West 23rd Street, Suite 500 New York, NY 10011 Tel.: (212) 244-7181 Fax: (212) 244-7185 Published by Dental Tribune America © 2011 Dental Tribune America, LLC All rights reserved. Cosmetic Tribune strives to maintain utmost accuracy in its news and clini- cal reports. If you find a factual error or content that requires clarification, please contact Group Editor Robin Goodman at r.goodman@dental-tribune.com. Cosmetic Tribune cannot assume respon- sibility for the validity of product claims or for typographical errors. The pub- lisher also does not assume responsibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune America. Do you have general comments or criti- cism you would like to share? Is there a particular topic you would like to see articles about in Cosmetic Tribune? Let us know by e-mailing feedback@ dental-tribune.com. We look forward to hearing from you! Tell us what you think! patient outcome — especially in deep preparations — more pre- dictable. Removing decayed dentin with Smartburs II Step 1: In order to use the Smartburs II properly, an operat- ing range of 5,000–10,000 rpm in a standard slow speed is ideal and increases the longevity of the bur. In addition, a light brushstroke is used during operation, essentially teasing out the carious tissue. This is a significant departure from previous techniques using traditional carbide and diamond burs. Step 2: When treating a carious lesion, it is critical that sharp and ragged enamel edges be removed with an appropriate high-speed bur before introducing the Smart- burs II to avoid dulling the instru- ment. The Smartburs II is then intro- duced into the center of the lesion. This helps to avoid unnecessary initial contact with healthy enamel and dentin that could prematurely dull the bur. Step 3: Starting in the center of the lesion, the most superficial, softest decay is removed using the largest size Smartburs II. The next smaller size Smartburs II is then worked laterally, removing layer by layer throughout the lesion, finally cleaning the entire cavity floor. The removal of caries to the cavity floor in one area only will prematurely dull the instrument and make caries removal in adja- cent areas more difficult. It is important to emphasize that contact of Smartburs II with hard enamel, healthy dentin or restorative materials will result in dulling and premature failure of Smartburs II. Step 4: The last action with the Smartburs II is to clean the cavity floor with more forceful strokes. Here you will have increased tactile sense when encountering decay versus using standard car- bide burs. This enables the conservation of healthy tissue when the self- limiting action of the Smartburs II instrument is experienced. After using the Smartburs II instrument, a careful examination of the area is required to confirm complete decay removal. Case report A patient reported with the chief complaint of having cavities in his upper front teeth (Fig. 1a). He reported no discomfort, but was self-conscious about his appear- ance. Upon examination, the maxil- lary anterior teeth were diagnosed with both Class V and Class III carious lesions. A treatment plan was formed that would include the restoration of these teeth using a direct com- posite resin technique with the possibility of root canal therapy where required. Following the administration of local anesthesia, the cavity prepa- ration for the maxillary right cen- Clinical COSMETIC TRIBUNE | February 2011 f CT page 1C 2C Fig 2: The tissue was retracted and all ragged and sharp enamel edges were removed. Fig 3: A #6 Smartburs II instrument was used to begin gross caries removal. Fig 4: The preparation with the bulk of carious dentin now removed. Fig 5: Complete removal of remaining infected tooth material was accomplished with a #4 Smartburs II instrument. Fig 6: The completed preparation. Fig 7: The completed Class V direct resin restoration.