How to not hit the adjacent tooth during crown prep!

[rsweeney]

What works for you?

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[Dr.BadVibes]

I use matrix bands

 

[crazy_sherm]

What are you using to break your proximals? I usually use a 878-012 to break and create the eggshell, then follow up with the 016 or 014.

 

[psiyung]

Remember that the tooth tapers on the way down, so what I do is I act like I'm doing a class II from the occlusal, and I bring the bur all the way down to the cervical 3rd of the tooth. Then I just extend the outline facially and lingually.

 

[DrJeff]

What works for you?

Who cares Just do 2 crowns instead of 1!

In all honesty, one of the biggest tricks that I've found over the years is to get your occlussal reduction done 1st. Not having to cut through that 1.5 - 2.0mm of occlussal/incisal structure out of the way often makes a HUGE difference in "mauling" the adjacent proximal surfaces

 

[Bifid Uvula]

What works for you?

Going into a completely different specialty!

 

[DcS]

In all honesty, one of the biggest tricks that I've found over the years is to get your occlussal reduction done 1st. Not having to cut through that 1.5 - 2.0mm of occlussal/incisal structure out of the way often makes a HUGE difference in "mauling" the adjacent proximal surfaces

They didn't teach it to you that way in dental school? I thought the common sequence was occlusal reduction, facial/lingual and then interproximals last. At least that's the way we were taught it.

 

[QTpieDMD]

They didn't teach it to you that way in dental school? I thought the common sequence was occlusal reduction, facial/lingual and then interproximals last. At least that's the way we were taught it.

I was taught occlusal, interproximal (just enough to break the contact), facial, then lingual. Then connect the facial to the lingual carefully.

 

[OMFSCardsFan]

Going into a completely different specialty!

Good answer...

I used a matrix band doubled over, but then again, I used a Striker...

 

[jpollei]

They didn't teach it to you that way in dental school? I thought the common sequence was occlusal reduction, facial/lingual and then interproximals last. At least that's the way we were taught it.

Truth is, plastic teeth cut way too easy. In the mouth it's not really a worry unless you have a soft amalgam adjacent or something.

Best trick for me: bikini strip the adjacent tooth after prepping the one you want.

 

[simpledoc]

Remember that the tooth tapers on the way down, so what I do is I act like I'm doing a class II from the occlusal, and I bring the bur all the way down to the cervical 3rd of the tooth. Then I just extend the outline facially and lingually.

well said! i do exactly the same and the prosthodontists in dental school taught me the same way.
also, i have found the thin tapered carbide (699) bur (single or may be 2 uses only) to be extremely cheap and useful for this step.

 

[DrJeff]

They didn't teach it to you that way in dental school? I thought the common sequence was occlusal reduction, facial/lingual and then interproximals last. At least that's the way we were taught it.

You'd be suprised how quickly you might stray from the academic ways after a while I've heard countless lecturers on the continuing education circiut emphasizing that proximal reduction should be first, because the full height of the occlussal table will give you a better view of your axial wall convergence taper than a reduced occlussal height.

The biggest thing, is that whatever sequence you find that you feel comfortbale with, stick to it.

 

[Bifid Uvula]

Good answer...

I used a matrix band doubled over, but then again, I used a Striker...

Hall drill in the clinic, Striker in the OR.... I prefer the hall drill though. More power.. arh arh arh

 

[OMFSCardsFan]

Hall drill in the clinic, Striker in the OR.... I prefer the hall drill though. More power.. arh arh arh

Good Lord...Tim "the Tool Man" Taylor is going through an OMFS residency...that can't be good for hospital insurance...

 

[Bifid Uvula]

Good Lord...Tim "the Tool Man" Taylor is going through an OMFS residency...that can't be good for hospital insurance...

Yah, i've tweeked a few things around here already.

 

[rsweeney]

Great posts! I found that using only the thinnest yellow chamfer for the proximals reduces adjacent tooth annihilation--I may hit the tooth but this bur doesn't cause much damage (as long as you don't push too hard ).

Anyway, thank you for the posts. I will certainly follow up on all the suggestions and see what works the best for me.

 

[Woodsy]

if u do accidentally hit the adjacent tooth say on a test this is what you do to cover it up. As long as it is just a slight nick, take ur slow speed, use softflex disc and smoothen it all away.

if not use matrix band to cover the adjacent.

 

[sjdent]

In the mouth, I'm finding that it's just not a big issue. I remember that in lab, I was super concerned about nicking the adj. tooth. I probably just don't notice it when I do it in a real person's mouth Anyhoo, you can always "fix" what you did in a real mouth with Soflex discs. In lab - I don't know.....go slow, use loupes, and no coffee before lab!

 

[ItsGavinC]

In the mouth, I'm finding that it's just not a big issue. I remember that in lab, I was super concerned about nicking the adj. tooth.

So true. Completely different story in a patient's mouth verses an ivorine tooth.

 

[LA DENTIST]

What works for you?

be careful

 

[drhobie7]

Hall drill in the clinic, Striker in the OR.... I prefer the hall drill though. More power.. arh arh arh

On the positive side, there's no way the lab tech will miss the margins.

 

[Bifid Uvula]

On the positive side, there's no way the lab tech will miss the margins.

I'm also a fan of shoving an elevator between adjacent teeth... get a little seperation this way as well...

 

[ElCid]

"You guys want to know the secret on how not to hit the adjacent tooth? Okay, right before you get to the adjacent tooth - STOP!"

Thats what my genius FP prof said when we asked him.

 

[Int. Dentist]

Hello, if you hit the adjacent tooth (slightly) during a preparation will that disqualify you? For a bench test, when applying to a dental school as an international dentist

 

[BluntForceTrauma]

You just revived a thread that was 13 years old. Holy $!#!.

 

[Int. Dentist]

You just revived a thread that was 13 years old. Holy $!#!.

I know, jajaja, but it doesn’t matter how old it is, it was discussing about the topic I’m interested!!

 

[Rambunctious]

Do dentists use matrix bands??? I thought that was a dental school thing only

 

[Incis0r]

I use wooden wedges and then a thin bur. Great results every time.

 

[AONLINE]

In our Pros courses they taught us to use a skinny diamond bur and slowly created an "eggshell" until that shell is so thin that it will break off. I personally did not use wooden wedges. For the licensing exam they recommend us wrapping matrix bands around adjacent teeth and then wedge it.

 

[Thaxil]

I usually take about 15 mins to crown prep. I first start with occ and axial reduction with a 557. Then I blow through the contact with the 557 leaving only a sliver of enamel against the adjacent tooth. lastly, I round the chamfer and corner with an oversize fat chamfer diamond.