Class II slot prep, please help

[DancingKoala]

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Hi guys. I am a dental student who has problem visualizing class II slot prep. I can't see what I prep because it goes so deep. I tried both direct and indirect vision. I have changed mirror angle but I still can't visualize what I prep. How can you guys even see the gingival floor when the view is blocked by the tooth, adjacent tooth, and the fast speed handpiece? Any tips?

 

[HupHolland]

unfortunately, this is a practice makes perfect and "feel" thing.

I take a 245 and drop in straight down at the marginal ridge breaking gingival contact, then move the bur buccal and lingually until I can see slightly breaking buccal/lingual contacts. At this point I stop, look at the prep with my mirror and make adjustments as necessary to remove caries and make smooth. Like I said, after time this all becomes second nature.

Do you have loupes and a light?

Hup

 

[DancingKoala]

unfortunately, this is a practice makes perfect and "feel" thing.

I take a 245 and drop in straight down at the marginal ridge breaking gingival contact, then move the bur buccal and lingually until I can see slightly breaking buccal/lingual contacts. At this point I stop, look at the prep with my mirror and make adjustments as necessary to remove caries and make smooth. Like I said, after time this all becomes second nature.

Do you have loupes and a light?

Hup

First of all, thank you for answering my question.

I have loups and a light. However, I still can't visualize what I prep. I am really good and comfortable prepping class I because I can see everything. I can see the tip of my 330 bur and I can see the pulpal floor very clearly. But I can't see my 245 bur nor gingival floor when I prep class II.

I am sorry if I misunderstood what you said but you said you use the mirror AFTER you prep. Does that mean you basically prep WITHOUT visualizing what you prep but just go with 'feel'? Aren't you worried that you might overprep, go too deep sub gingival, or nick the adjacent tooth?

 

[djeffreyt]

Actually, yes, many dentists prep without looking directly into the floor of the prep. Don't forget, even if there was no water spray and a good angle on the mirror, chances are that at times you will not see everything cause the head of the handpiece will block your view. After you cut a few hundred, or maybe even before that, you'll get the feel for cutting the teeth and can tell from just seeing the part of the bur that is visible just how deep into the prep you are and how much axial depth you've created.

Until then, it is cut and check. Sometimes you will have a perfect view, many times you won't. So use the landmarks to help you and cut a little bit at a time and then check. If you know the length of the cutting edge of your bur is 1.5 mm or 2 mm, use it as a guide. There is a reason in dental school you only do a couple fillings in a session when you first start, cause you need to learn the tactile sense, and you don't get that right away.

 

[DancingKoala]

Actually, yes, many dentists prep without looking directly into the floor of the prep. Don't forget, even if there was no water spray and a good angle on the mirror, chances are that at times you will not see everything cause the head of the handpiece will block your view. After you cut a few hundred, or maybe even before that, you'll get the feel for cutting the teeth and can tell from just seeing the part of the bur that is visible just how deep into the prep you are and how much axial depth you've created.

Until then, it is cut and check. Sometimes you will have a perfect view, many times you won't. So use the landmarks to help you and cut a little bit at a time and then check. If you know the length of the cutting edge of your bur is 1.5 mm or 2 mm, use it as a guide. There is a reason in dental school you only do a couple fillings in a session when you first start, cause you need to learn the tactile sense, and you don't get that right away.

Thank you. That really helps alot. No one told me to prep blindly and it always made me force myself visualizing something that can't be visualized. I guess I should've just came up with a blind method instead of struggling the entire year. Only if I knew earlier....😡

 

[saru24]

A fiberoptic light will help you visualize better. Once you try it, you probably won't go back.

I can see everything I prep with a mirror. It just takes practice. You don't only play with the angle of the mirror, but also, how far you hold the mirror from the prep. I cut everything from 12 o'clock position. But what works for me, won't work for someone else of course, just my 0.02.

 

[mentlegen]

A fiberoptic light will help you visualize better. Once you try it, you probably won't go back.

I can see everything I prep with a mirror. It just takes practice. You don't only play with the angle of the mirror, but also, how far you hold the mirror from the prep. I cut everything from 12 o'clock position. But what works for me, won't work for someone else of course, just my 0.02.

This. I keep my mirror moving all the time when I'm prepping the proximal box.