Switching gears

[aphistis]

We finished single tooth direct restorations Monday, and today we started single tooth indirect. One more module in the books, and one fewer standing in the way of graduation!

I'm finding that prepping isn't necessarily too hard. Most of my mistakes anymore are due to carelessness or inexperience on a particular prep design, and not broader lack of ability. What I'm wondering, though, is how many different sets of rules we'll have to internalize. I ask this because the specs for our DO inlay prep are almost diametrically opposite from our old amalgams (size, diverge/converge, bevels, etc). I imagine the same will apply next year and beyond as we start learning more advanced stuff. To the wizened old blowhards here on the board, () Does this stuff become second nature, or do you still find yourselves having to think about the procedure before hitting the rheostat (or power switch, Gavin)?

And, this is totally unrelated, but I'm still frustrated that I can't carve a larger amalgam worth a rat's rear end.

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[DrJeff]

Bill, just like anything, with practice it becomes second nature. Before you know it, the only thing you'll be thinking about when you're doing a direct restoration prep vs. and indirect restoration prep is what bur you're going to put in the handpiece. (and believe me there are ALOT MORE burs out there than what they're currently giving you at Indiana. Finding what bur works in YOUR HANDS as opposed to what works in your course directors hands makes a huge difference(for example between my partner and I, our crown and bridge bur blocks each hold 10 different burs(realistically we only use 3, but our assistants feel insecure unless the bur blocks are filled ), we only have 2 burs in common (the diamond equivalent of a 330 for depth cuts and a diamond football for gross occlussal reduction, the rest totally different for our own preferences - and when one of our assistants grabs one of the other's bur blocks for crown preps, we both mutter to our selves, "how can he cut a prep with these shaped burs?" )

As for amalgam carving, the same thing goes, practice, practice, practice.

BTW, here's a good line for you, I was at an endodontic continuing education lecture today given by Dr. Stephen Buchanon (the guy that invented the rotary Profile GT endo burs) and he was giving a mock graduation lecture by a dental school Dean, saying "I've got some good news and some bad news for you. The good news is half of everything we taught you in dental school is wrong, the bad news is, we don't know which half that is! " His follow up to that is to not be afraid to "think outside the box" because there likely is a better, more efficient way to do the procedure infront of you that either hasn't been discovered yet either by you, or the profession.

 

[ItsGavinC]

Bill, excellent post. I hear you loud and clear.

For what it's worth (not much!) my amalgam preps are stinky as well. My composites are da bomb, however!

I agree with Dr. Jeff about finding what works. I already have my own little things I do that make my environment more comfortable for me, and allow me to perform better.

For example, on these ivorine teeth, I don't ever push my drill speed past 1/2 of what it can do. I feel like it gets away from me if it is about half, much less at full rpms. Of course, I didn't figure out that I even COULD lower the speed until 2 weeks into prepping. It made a world of difference for me.