indirect vision on the mandibule

[scicsasci]

im starting operative now and im not sure about indirect vision on the mandible.

for maxillary i have okay control but:

1. do you even use indirect vision on the mandible? i feel like when im doing proximal boxes for example on the mesial the distal of the adjacent tooth blocks my view and i have to try and use the mirror. which portions of the mandible specifically are good to practice indirect vision on?

2. different angulations of the mirror mess up my indirect vision skills. for example, indirect vision of maxillary anterior linguals feel different than indirect vision of mandibular posterior linguals, since for the former im positioning my mirror towards me and the latter im positioning ny mirror perpendicularly to me (to see the lingual surface of the posteriors). this changes how I perceive movements of my hand as I look into the mirror. particularly, when my mirror is perpendicular to me, i have a lot of trouble controlling my movements. am I doing something wrong?

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[bracketbuster68]

Assuming you're a righty, if you are working on the right side of the mandible, move the head and have it facing all the way to the left. Adjust it as necessary to have a better view of the occlusal etc. Make sure you're sitting at around 7-8 o'clock and not behind the patient.
If you're working on the left side of the mandible, move the head to the right all the way just like before. Adjust as necessary. Sit at around 11-12 o'clock.
This should make all movements easier to perceive in the mirror. If it's still off, you need to adjust the head a bit more such that the facial of the tooth you will be working on is directly facing you.

This is what I do for crowns, but I'm guessing it should work for operative. By moving the patients head all the way to the side, it allows you to focus on the tooth you're working on and indirect movements should be simplified. If you don't angle the patient's head, you have to work indirect in multiple axes and that is too hard. Really for operative, I used direct as much I could. I also found drilling with touch perception to be way more helpful with my box than indirect vision. Hold the handpiece very gently and lightly such that you can feel the bur cutting when you use it. Shape the box with a 169 carbide. $$$.

Hope that makes sense

 

[Tootyfruity]

on a manikin for grades, direct all the way

on live patients you're gonna have to learn indirect, they hate it when you move their heads around
so i would practice like that for the most part
the further back your mirror is the bigger the field of view
try to avoid weird oblique angles, stick to straight on views that match the planes of the tooth
wave the bur around a little bit before you cut anything to get your bearing

 

[bracketbuster68]

Also just wanna stress that indirect comes with time. I remember thinking I could never learn it in operative, but once I got to prostho lab, I learned how to use the mirror and avoid oblique angles. Indirect will come!

 

[setdoc7]

Sit up straight and use the mirror. Your back will thank you in 20 years.