dental practice July 2009
www.dental-practice.org
Getting smart in endodontics!
Roger Jenkinson reveals how he embraced ‘a better way’ for his endodontic restorations...
I
HAVE been practising dentistry endodontic product called smartseal.
for nearly 40 years and throughout A new concept in root canal fillings
that time I have remained that made scientific sense, I first
open-minded to new products and read about smartseal around October
techniques on the market. 2007. If a product or technique can
I have never approached my scientifically and logically demonstrate
profession, or indeed any aspect of that change is worthwhile; if it suggests
my life, with the attitude that once I can achieve a better outcome for
I knew how to do something it my patients while simplifying my
couldn’t be done better, and it was technique, then that product is worthy
this outlook that led me to try a new of my interest.
FIG 1
FIG 2
Tooth Prep with Paul Tipton
completed by using a 1mm tapered
Continued from page 17
round-ended diamond bur to cut the
Remaining tooth structure is then required axial inclination of 6 degrees
reduced evenly. If the tooth to be and the 0.5mm chamfer finish line at
prepared is in guidance then the full the same time.
1mm reduction is required over the Proximal reduction is started with a
whole occlusal surface. If, however, the thin tapered diamond bur in order to
tooth is not in guidance, then the gain access to the area and not to
reduction is reduced towards the reduce the adjacent tooth. Thicker burs
buccal cusp tip to reduce the amount are introduced sequentially until the
FIG 10 – the offset is cut so that it follows the
FIG 11 – the final preparation involves a 0.5mm
of gold visible. 0.5mm supragingival chamfer is
buccal cusp outline in a shallow “v”
bevel on the buccal cusp tip using a fine diamond or
There is the requirement for an extra produced. It is important to angle the 0.5mm in depth. These grooves
carbide bur in a speed-increasing handpiece. Make
0.5mm reduction on the functional preparation slightly to the palatal so as increase the resistance and retention
sure you have a “line of draw” from the buccal
cusp (functional cusp bevel – palatal not to compromise the amount of
before taking your impressions. This is done by
form and give structural rigidity to a
“wiping” the bur over the buccal cusp
cusp of uppers and buccal cusp of mesio buccal tooth preparation and thin margin so as to stop flexion during
lowers), and is prepared at a 45-degree show of gold. cementation.
angle to the long axis of the Grooves are now added at the mesio The occlusal offset is a 1mm wide
preparation. and disto buccal line angles. They ledge that joins both grooves together
The lingual axis reduction is should be placed as far buccally as and stays a uniform distance away from
possible without undermining the the buccal cusp tips. It is prepared with
buccal surface. The groove will finish the edge of a flat-ended tungsten
0.5mm above the chamfer finish line carbide bur to produce a V-shaped
with a definite step and should be a full ditch. The purpose of the offset is for
structural rigidity, over the occlusal
surface.
FIG 12 – prepare tapered grooves with
Finally a facial bevel is placed along
supragingival margins mesio-buccally and disto-
the occlusal-buccal line angle. The
bucally using speed-increasing handpiece and
carbide bur
bevel should be no more than 0.5mm
to reduce the amount of gold showing
FIG 6 – break through mesially with long thin
and prepared with a tungsten carbide
diamond and increase width until thin chamfer
bur. The bevel is carried onto each of
bur can produce supragingival margin without
damaging the adjacent tooth
the proximal surfaces and merges into
FIG 8 – the groove should be angled towards the
the proximal flares.
opposite corner of the tooth and half the depth
The three-quarter crown preparation
used. The mesial groove should not be seen from
on mandibular premolars and molars
the front of the mouth and should be hidden by the
differs from the maxillary because the
distal aspect of the canine tooth buccal cusps of the mandibular
FIG 13 – completed preparation in position
posterior teeth are the functional
cusps. The buccal margin is therefore occlusal margin. The buccal margin is
brought further down the buccal cusp. prepared in the form of a 0.5-1mm
Otherwise an unprotected cusp might shoulder (plus bevel) 1mm down from
fracture or wear near the buccal- the opposing tooth contact.
FIG 7 – place the mesial groove the same way
using the carbide tapered bur with speed-increasing
Paul Tipton heads Tipton Training and teaches tooth
handpiece. Angle the bur so that it is upright and
preparation techniques in his “Practical Phantom Head
you have a “line of drawer” when looking from
Course” held at ManDec, Manchester, on KaVo phantom
the buccal. Then flare the groove to the cavo surface
heads. For information, contact Louise Saunders on
margin using a flame-shaped fine diamond or
FIG 9 – the offset is there to strengthen the thin
carbide bur in a speed-increasing handpiece. The
telephone 0161-602 3130, e-mail louises@tiptontraining.co.
occlusal cavo-surface margin and give structural
angle should be the same as the palatal wall
uk or visit www.tiptontraining.co.uk.
rigidity. Use speed-increasing handpiece
18
DP July 09 8, 10, 12-20, 22.indd18 18 24/6/09 13:39:59
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