15-minute crown prep

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From what i've read there are mixed reviews of the peeling enamel method. I guess it would work for some but i think most prefer the more conventional method.
 
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CJWolf said:
From what i've read there are mixed reviews of the peeling enamel method. I guess it would work for some but i think most prefer the more conventional method.
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What reviews are you referring to? I'd like more info on it before trying it. It seems like a better way than grinding through all that enamel with a diamond. Can't try it on plastic teeth so I'll try it on extracted ones.
 
ItsGavinC said:
I don't know much about the technique, but it seems that those burs are all the rage on DentalTown.
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That's where I first saw them. Talked to the rep at the Chicago Midwinter and got a couple of freebies. I'll try them after break.
 
ItsGavinC said:
I don't know much about the technique, but it seems that those burs are all the rage on DentalTown.
Click to expand...


How can we know anything about the "technique"? This link doesn't tell us anything but "buy my secrets!" It sounds like one of those gimicks on TV at 2am where they are selling their "secrets" to making money...then they just sell you a job listing from the classifieds.
 
I've merely read on DT where people disuss the pros/cons of enamel peeling and doing such speedy preps. Some like it and some don't. I'd be interested in trying it ... after someone i knew did.
 
toofache32 said:
How can we know anything about the "technique"? This link doesn't tell us anything but "buy my secrets!" It sounds like one of those gimicks on TV at 2am where they are selling their "secrets" to making money...then they just sell you a job listing from the classifieds.
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Gordon Christiansen sells his "secrets", but people still consider him a dental god. Every article in the free dental magazines has the products mentioned in the story directly across from it. Dentistry is big business and people aren't just going to give this stuff away without some catch. That's the way it is and we need to be aware of that. Take this stuff with a grain of salt, but there's still info to be gleaned from it. By the way, if you go to SS White's "clinical corner", there's a link to a more in-depth article on enamel peeling.
 
Didn't read much about the link but I know in our clinics (UNC) they've got "Great Whites", the bur he refers to and those things are the absolute ****e to cut off crowns. I can tell you that much by experience.
 
Dr. Scott Perkins has a new bur that is supposedly better than Great Whites.

It is called the Samurai Precision Bur.

The link is here.
 
The guy makes some good points, especially this one:

To many this will seem completely iconoclastic but topical is absolutely one of the most useless products dentists have ever wasted their time with.

Once the patient is seated and you have said, "Hello Mr. Smith how are you doing today?" you give anesthesia. Don't use topical. Topical doesn't do anything. Wait a minute. Let me take that back. It does do something. It makes the patient salivate, choke and gag, come up out of the chair, beg for suction and take up precious time. And then you have to come up with some cute response like, "It's supposed to taste like pina colada but they haven't quite perfected it yet". Or you make some other weak apology for the poor taste. Then you have to wait around for it take effect. Then when it does take effect your patient may still feel pain. It's not the initial needle stick that hurts patients, it's the pressure of the injection that hurts. Topical does create a sensation of numbness superficially but that's about it. You may think that topical works well because you give a buccal infiltration after using topical and the patient didn't feel anything. They wouldn't have felt anything anyway. For mandibular blocks, topical is particularly ridiculous. The hypodermic needle passes through at least twenty millimeters of tissue that topical could never penetrate.
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I hate topical. When I train hygienists to give injections I try to impart my bias to them as well. It helps that we don't carry topical in our clinic.

I also like the quote about not grinding wood to shape, but, rather, cutting it to shape. Makes sense.
 
i don' know anything about that technique...
....but i do know dr perkins in big on not wasting movements.

..i can do a clean crown prep (prep only) in about 20-25 minutes/tooth now..and i haven't cut 8000 teeth yet.
...i don't think it's that difficult
the key is just don't waste time..
;-)

keep your bur on the tooth...and don't pause to admire your work until after you're done.
 
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toofache32 said:
How can we know anything about the "technique"? This link doesn't tell us anything but "buy my secrets!" It sounds like one of those gimicks on TV at 2am where they are selling their "secrets" to making money...then they just sell you a job listing from the classifieds.
Click to expand...

Good call.
 
gumgardener2009 said:
Is Scott Perkins trying to sell burs? I don't know. Why don't you email him? As I said before, there is more info on it at the SS White site. For those who like things handed to them here's the link: http://www.sswhiteburs.com/clinical_perkins2.html
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I did sell burs under the Samurai Precision Bur name. I stopped selling them a few years ago.

The bur has succeeded well and is sold under many names. In fact, it dominates the market in tungsten carbide steel burs these days. It is one heck of a bur.

I may start selling it again soon.

SSWhite no longer has my article, "The Enamel Peel Technique" on their website. I'll try to find an electronic version and post it here.

Meanwhile, here's the short version:

Spear the bur into the tooth entering from the buccal side and MB point angle aiming for the occlusal DEJ sinking the bur to the midline. Draw the bur back to the DB corner. Remove the bur from the tooth. Spear the bur from the lingual side and ML point angle aiming for the occlusal DEJ to the midline and draw it back to the DL corner. Since you are underneath the enamel, most of the bur is cutting through soft dentin increasing the speed of the cut.

The occlusal enamel is lifted off the tooth.

Next, spear the tooth from an occlusal direction into the DEJ towards the gingival margin. Travel counter-clockwise peeling the axial enamel off the tooth.

Enamel is now gone from the tooth.

Refine the "roughed in" prep with a medium chamfer diamond.

The Good: Minimal trauma to tooth, patient and dentist. Less treatment time.

The Bad: Requires the use of 2 burs and switching burs during the procedure.

I used the SSWhite bur in the beginning. In fact, I popularized that bur when i wrote "The 15 Minute Crown Procedure". I also sold thousands of "The 15 Minute Crown Procedure" Video, which taught the technique. Probably every dentist that watched that video bought Great White burs from SSWhite. I can't count the number of dentists who would approach me and tell me the best thing they learned in the video was the use of the GW#2 bur. I had no financial interest in SSWhite.

These days the GW2 has been superceded in speed and longevity by burs like the Samurai.

Nothing wrong with selling things. We all do it. Every time you do a case presentation, you are selling something. There is something wrong with being dishonest when selling.

Selling something to a patient or another dentist can be a good thing if it has value, particularly if the value is greater than the money you are asking for it.
 
Hey Dr. Perkins, thanks for the great article, I read it awhile ago.

I had a chance to watch Omar Reed's 5 min crown prep video which helps visualize it. From what you wrote, the principle of the methods seems similar...what are the differences between the two techniques?

Thanks!
 
scottperkins said:
I did sell burs under the Samurai Precision Bur name. I stopped selling them a few years ago.

The bur has succeeded well and is sold under many names. In fact, it dominates the market in tungsten carbide steel burs these days. It is one heck of a bur.

I may start selling it again soon.

SSWhite no longer has my article, "The Enamel Peel Technique" on their website. I'll try to find an electronic version and post it here.

Meanwhile, here's the short version:

Spear the bur into the tooth entering from the buccal side and MB point angle aiming for the occlusal DEJ sinking the bur to the midline. Draw the bur back to the DB corner. Remove the bur from the tooth. Spear the bur from the lingual side and ML point angle aiming for the occlusal DEJ to the midline and draw it back to the DL corner. Since you are underneath the enamel, most of the bur is cutting through soft dentin increasing the speed of the cut.

The occlusal enamel is lifted off the tooth.

Next, spear the tooth from an occlusal direction into the DEJ towards the gingival margin. Travel counter-clockwise peeling the axial enamel off the tooth.

Enamel is now gone from the tooth.

Refine the "roughed in" prep with a medium chamfer diamond.

The Good: Minimal trauma to tooth, patient and dentist. Less treatment time.

The Bad: Requires the use of 2 burs and switching burs during the procedure.

I used the SSWhite bur in the beginning. In fact, I popularized that bur when i wrote "The 15 Minute Crown Procedure". I also sold thousands of "The 15 Minute Crown Procedure" Video, which taught the technique. Probably every dentist that watched that video bought Great White burs from SSWhite. I can't count the number of dentists who would approach me and tell me the best thing they learned in the video was the use of the GW#2 bur. I had no financial interest in SSWhite.

These days the GW2 has been superceded in speed and longevity by burs like the Samurai.

Nothing wrong with selling things. We all do it. Every time you do a case presentation, you are selling something. There is something wrong with being dishonest when selling.

Selling something to a patient or another dentist can be a good thing if it has value, particularly if the value is greater than the money you are asking for it.
Click to expand...

Hey Scott! Great to see you back!:)
 
Whenever you are presented with a technique like Scott's it is always important to keep an open mind and see what you can learn from it. All too often dentists can be guilty of immediately turning their noses up at anything that departs from what they view as "the gospel". "15 minute crown preps!! Snake oil!! Now where did I put my copalite.":D

When I read Scott's technique many years ago on Dentaltown I really appreciated his economy of movement (my dad was an Industrial Engineer). To me things like pre-packaging burs and cord were a very smart way of saving on time and in a dental practice time is money.

Great to see you back Scott:thumbup:
 
tx oms said:
The guy makes some good points, especially this one:



I hate topical. When I train hygienists to give injections I try to impart my bias to them as well. It helps that we don't carry topical in our clinic.

I also like the quote about not grinding wood to shape, but, rather, cutting it to shape. Makes sense.
Click to expand...

The topical that you can buy from Patterson like Hurricane is about useless. Have your pharmacist compound some tricane blue (also known as Profound) for you and you will forever change the way that you think about topical
 
The Hammer said:
The topical that you can buy from Patterson like Hurricane is about useless. Have your pharmacist compound some tricane blue (also known as Profound) for you and you will forever change the way that you think about topical
Click to expand...

I read a thread on DT about tricane blue and how some dentists were getting pulpal anesthesia with it. Is this true?

Hammer, do you use it and if so in what applications?
 
lotexigeus said:
I read a thread on DT about tricane blue and how some dentists were getting pulpal anesthesia with it. Is this true?

Hammer, do you use it and if so in what applications?
Click to expand...

Tricaine Blue/ Profound is a compound of Prilocaine / Lidocaine / Tetracaine with peppermint for flavoring (it still taste bad). The reason this stuff is so good is that unlike other topicals it will actually penetrate completely through the mucosa. I can get anesthesia on the upper incisors using it. I use this as my pre-injection topical. If you use Tricaine first, then some Citanest Plain and finally some Septocaine you can give true pain free injections that get the patient profoundly numb.:thumbup:


http://dentalpharm.com/DentalPharm_Office_Use_Prod.html
 
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