Help with class II amalgam preps

[suprmssiv]

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Hi all, been a lurker for a while and finally got a question to ask all of you!

I've been having a lot of difficulty doing class IIs in the mannikin. For instance, take #19 for example... how would you position your body/hands/bur to get maximal positioning? I'm having a lot of trouble with access and nothing has really worked well for me. I've tried 12 and 8 o clock, and fulcruming off #20, but I still find it hard to cut straight, etcetc.

Thanks for any help😀

 

[Streetwolf]

Hi all, been a lurker for a while and finally got a question to ask all of you!

I've been having a lot of difficulty doing class IIs in the mannikin. For instance, take #19 for example... how would you position your body/hands/bur to get maximal positioning? I'm having a lot of trouble with access and nothing has really worked well for me. I've tried 12 and 8 o clock, and fulcruming off #20, but I still find it hard to cut straight, etcetc.

Thanks for any help😀

I'll often start the prep at a standard position between 10-11 o'clock. If I need to look at a different angle while dropping or adjusting the box, I might sit so that I am looking in the same direction as the box... In other words the way I am facing is perpendicular to the M-D direction of the tooth.

 

[armydds]

Hi all, been a lurker for a while and finally got a question to ask all of you!

I've been having a lot of difficulty doing class IIs in the mannikin. For instance, take #19 for example... how would you position your body/hands/bur to get maximal positioning? I'm having a lot of trouble with access and nothing has really worked well for me. I've tried 12 and 8 o clock, and fulcruming off #20, but I still find it hard to cut straight, etcetc.

Thanks for any help😀

Generally you're supposed to sit around 9-10 o'clock if you are right handed when working on the mandible. You want the manikin head to be perpendicular to the floor (basically pretend the person is looking, chin toward the chest). This allows pretty good access. Position the burr? Not sure what you mean but generally you are supposed to fulcrum one tooth adjacent or two depending if you have a big hands. Utilize your mirror when you are dropping the box. Cutting straight just takes a bunch of practice. Take some old plastic teeth and keep on cutting class I's until you get a perfect 1.5-2mm depth all around and smooth cavosurface margins etc. Minimize the use of the burr when dropping your box and stick to hand instruments in smoothing everything.

 

[Edentulator]

Sometimes I find it helpful to hold the handpiece further down on the handle, then I can put a finger rest on the quadrant closest to me and extend the handpiece over to the tooth I'm drilling. From there, the movement is entirely in the fingers, a bit like writing. You'll want to keep the bur parallel to the long axis of the tooth, at least until you feel like your movements are more refined and controlled.

You can go by feel too, but this takes a bit more thought and practice. You can visualize the tooth and the prep in your head, then combine it with proprioception to gauge where you are and what you're cutting. This is better for fine adjustments like gaining clearance or smoothing axial walls when the handpiece is obscuring your view of the prep. If in doubt, treat your bur like a small paintbrush and use light strokes to slowly get to where you need to be.