how to break contact without damaging adjacent tooth

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
B

bballrules

Full Member
10+ Year Member
15+ Year Member
Joined
Mar 13, 2008
Messages
61
Reaction score
0
hey guys, i'm having so much trouble breaking contact without damaging the adjacent tooth. no matter how many times i do it, i can never do one perfectly. i've done about 7 class IIs on real patients and i always knick the adjacent tooth. I just can't do everything with the 330 or 245. I always have to switch to the 699 or even use hand instruments to make the box. i've tried pre-wedging but that is not really helping me either. anyone have any advice on how to get better? are there things i should do differently? any good youtube videos to explain? thanks!
Members don't see this ad.
 
take a matrix band and it fold it to be 4 layers thick and place it between the wedge and teeth
 
I angle the bur so that it only cuts at the most gingival portion of the box where the contact should be open so that you won't hit the adjacent tooth. Since this causes the enamel rods to become unsupported, the rest of the enamel shell should flake right off.
 
Members don't see this ad :)
thanks Streetwolf, this will help so much. i've never thought about this before. do you pre-wedge? thank you!
 
bballrules said:
hey guys, i'm having so much trouble breaking contact without damaging the adjacent tooth. no matter how many times i do it, i can never do one perfectly. i've done about 7 class IIs on real patients and i always knick the adjacent tooth. I just can't do everything with the 330 or 245. I always have to switch to the 699 or even use hand instruments to make the box. i've tried pre-wedging but that is not really helping me either. anyone have any advice on how to get better? are there things i should do differently? any good youtube videos to explain? thanks!
Click to expand...

Switch from the 330 to a 329 (still, with a wedge). I noticed it help me a whole lot in the pre-clinical lab but I dont have the experience to know how it stacks up while working on patients
 
leave a sliver of tooth structure between your box and the adjacent tooth and then knock it off with a hand instrument or a non-spinning bur. Use an end-cutting bur to smooth out the bottom of the box.
 
Like the posters said above, pre-wedge and take a matrix and fold it as many times as you can. Leave a small amount of unsupported enamel and chip away at it with a hatchet. Sometimes, I'll use a needle bur or finishing strip to break that last bit of contact.
 
Last edited by a moderator:
i was told some statistics at a conference not too long ago that 90% of dentists cause some level of iatrogenic damage to adjacent teeth during class II preps.....
 
lemoncurry said:
leave a sliver of tooth structure between your box and the adjacent tooth and then knock it off with a hand instrument or a non-spinning bur. Use an end-cutting bur to smooth out the bottom of the box.
Click to expand...

i wonder what percentage of private practices actually have enamel hatchets? I wonder what other hand instruments in a common instrument issue would work as well as an enamel hatchet that is more likely to be had once out of dschool? I know that up in clinical at IUSD the restorative cassettes don't always come with any enamel hatchets... Any thoughts?
 
Doc Smile said:
i wonder what percentage of private practices actually have enamel hatchets? I wonder what other hand instruments in a common instrument issue would work as well as an enamel hatchet that is more likely to be had once out of dschool? I know that up in clinical at IUSD the restorative cassettes don't always come with any enamel hatchets... Any thoughts?
Click to expand...

How about a spoon?
 
Streetwolf said:
How about a spoon?
Click to expand...

I like where your head is at Streetwolf. But I dont think a spoon would fit in a mesial box
3992451451_f1fdc6004f.jpg

(its a joke btw)
 
bballrules said:
hey guys, i'm having so much trouble breaking contact without damaging the adjacent tooth. no matter how many times i do it, i can never do one perfectly. i've done about 7 class IIs on real patients and i always knick the adjacent tooth. I just can't do everything with the 330 or 245. I always have to switch to the 699 or even use hand instruments to make the box. i've tried pre-wedging but that is not really helping me either. anyone have any advice on how to get better? are there things i should do differently? any good youtube videos to explain? thanks!
Click to expand...
Try #557 bur.
 
flapaTron said:
i was told some statistics at a conference not too long ago that 90% of dentists cause some level of iatrogenic damage to adjacent teeth during class II preps.....
Click to expand...

Learn the art of repairing adjacent teeth ;) (fine flame diamonds)
 
you don't have to use the hatchet to break off the sliver of enamel. It is usually thin enough you can do it with the bur (non-spinning).
 
You must log in or register to reply here.
Next unread thread

Similar threads

D
Dental students drilling wrong tooth
Replies
8
Views
2K
coursedirector2005
coursedirector2005
D
Adex tooth 30 surface 2022
Replies
0
Views
2K
drtoooth3
D
A
tooth preparation practice
Replies
1
Views
887
oralcare123
O
T
Amalgam Contacts Too Heavy
Replies
2
Views
639
Blueshirts
B
toothdocindia
No spring break or break between spring and summer semesters
Replies
7
Views
2K
oralcare123
O
Top