Tooth Carving (#19)

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scottyhoop

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So I have found tooth carving to be very frustrating. I feel like I can get kinda sorta close to reproducing 19, but close isn't good enough. Any of you want to share your routine for carving with a newb such as myself??

Scotty

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carve it til it looks like the real thing. 😉
 
So I have found tooth carving to be very frustrating. I feel like I can get kinda sorta close to reproducing 19, but close isn't good enough. Any of you want to share your routine for carving with a newb such as myself??

Scotty

Carivng out of wax or soap?

Anyways, first of all, today was your first day of class. Stop. Take a deep breathe. Relax. Your fine motor skills aren't developed and your eye is not trained. It will take time and practice to develop these. It is not the easiest thing to describe how to do something like that through this forum. My suggestion would get in touch with an upperclassman and have them show you. You are going to learn much more there than you could here on SDN regardig this.
 
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Yeah...I know I'm not going to be an expert after my first week of carving, but I'm looking for ways people attack the tooth. Do you trace the outline of the tooth into the wax...do you heat up any instruments when you carve...that kind of stuff. I'm going to be meeting with some upper classmen next week for pointers, but if any of you have any good strategies I would love to hear them.

Scotty
 
Look for a technique known as additive waxing. You're likely trying subtractive (add a ton of wax and carve back) which in my opinion is harder for a DS1.
 
Look for a technique known as additive waxing. You're likely trying subtractive (add a ton of wax and carve back) which in my opinion is harder for a DS1.

I second that. I feel that it is easier to get more accurate anatomy if you do additive waxing. They didn't even mention it to us at Colorado until second semester, but do a little research into it and give it a go.
 
at UIC we carve teeth only for anatomy during the first semester. So we didn't actually put the teeth into occlusion. the main purpose was for us to get familiar with all the anatomy of each tooth.

then 2nd semester weactually began occlusal waxing and finishing tripod contacts.
 
Thanks...i'll try to do some homework on that and see what I come up with. I appreciate the tip!

Scotty
 
so for things such as carving teeth and other lab work for dental school (especially UIC), how do you get graded?? Do you just keep working on it during lab and have the instructor check up on you or is it due by a certain time and they give you a grade (A, B, C, D, F)?? thanks guys..
 
I'll second the comments on additive waxing. What I did was "draw" lines of hot wax to known points. You know where the proximal contact point is. Put some wax there. You know where the cervical margin of the wax-up has to be -- flush with the margin of the prep. Heat up a drop of wax on the tip of your waxer and "connect the dots." Connect the dots for all points you know. That will give you a scaffolding. Fill in the spaces with wax and your tooth will look close; you just need to actually carve the finer detail.
 
so for things such as carving teeth and other lab work for dental school (especially UIC), how do you get graded?? Do you just keep working on it during lab and have the instructor check up on you or is it due by a certain time and they give you a grade (A, B, C, D, F)?? thanks guys..

We are assigned a tooth to carve. I'm doing #19 now. It has to be checked off by the instructor by next wednesday and it is not graded. Once it's checked off I start on another tooth...#5 I believe. Then in a few weeks I have to take a timed practical (carve #19) in three hours and that is graded and I have to get checked off on #5 then start on the next tooth.

Scotty
 
We are assigned a tooth to carve. I'm doing #19 now. It has to be checked off by the instructor by next wednesday and it is not graded. Once it's checked off I start on another tooth...#5 I believe. Then in a few weeks I have to take a timed practical (carve #19) in three hours and that is graded and I have to get checked off on #5 then start on the next tooth.

Scotty

sounds fun..good luck
 
Here is my 2 cents.

You must understand that you cannot do a wax up adequately outside of the arch. This may seem stupid, but I have seen many a new dental student slave away on a wax up until it looks great... only when they put it in the arch it is all wrong.

I like the subtractive method myself. Build that sucker up to about 125% of what it should be and start shaping it back. Begin with the proper incisal/cusp tip placement (i.e. it should be in a line with the other teeth. Next carve out your embrasure spaces. If you do not know what these are, ask someone or look it up. Basically, they are the angles formed by the meeting of teeth. If I could, I would draw you a picture here, but I cant. Check the opposite teeth for an idea. There are LOTS of embrasure spaces to carve out. Once you get this concept in dental anatomy, then you will understand why Angle Ranking is the most relevant portion of the entire DAT.

Then move on to emergence profile, or at what angle the tooth comes out of the gingiva. Again, the other teeth in the arch will show you the correct angle. Then you need to dial in your occlusal anatomy. I cannot tell you how important it is to be able to do this well and to do it quickly. When you do your first occlusal fillings, then you will understand why you are forced to do this in a timed fashion, especially when the setting time of your material is around 5 minutes.

To do occlusal anatomy, first define your central groove. Then rough out your ridges. Again, consult the opposite tooth and the adjacent teeth to give you an idea for position of both the central groove and the ridges. I know this might seem a little premature, but if you develop a sequence and stick with it, then you will be working on an very relevant clinical skill. If you don't understand how to re-create occlusal anatomy then you will be forever adjusting your fillings and that sucks for you and your patient.

Once you have your wax up pretty much roughed out, then it is time to sexy it up. That has been explained pretty well elsewhere, so I wont go into that.

Let me just sum this up: wax ups are, in my opinion, training for restorative dentistry. Learn to get clues from adjacent teeth, learn to see and compare angles from those teeth. Try and work quickly. I would also recommend sticking with a carving instrument that you would find in an operative tray, such as a Tanner Carver or a Half Hollenbeck, because your wax carving skills will merge into your amalgam carving/composite shaping skills.

A little bit has been said so far about the additive method and the subtractive method. Both are ok, in my opinion for these reasons: amalgam carving will be mainly subtractive and composite will be additive. But for beginners, the subtractive method is the easiest. You dont want to spend an hour and a half adding wax slowly, only to realize that you added too much here and too little there. Just add too much and then you know where you are.

Good luck.
 
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If you're doing subtractive, you do NOT want to heat your instrument up when you carve down. After you put the chunk of wax on the stump, stick it back in the arch and mold the general shape with your hands. Use a buffalo knife to take off any gross excess. People gave pretty good advice for the outer surfaces. For the occlusal surface, it's important the cusps are in the right spot. We got penalized if any cusp made premature contact with the tooth on the opposing arch. Best way to avoid this? While the wax is still soft, occlude the typodont for the opposite arch with the arch you're doing the wax up for. The impression it leaves in your wax will show you where the grooves and cusps should be placed.
 
1. take a quadrant impression of the same tooth in the typodont, but one that hasn't been prepped for a crown.

2. after taking the impression, replace the non prepped one with the prepped one.

3. add heated wax to the inside of your impression of the tooth you are working on.

4. quickly seat the impression while wax is still liquidy.

5. let it harden for a minute.

6. modify and polish where needed.

save this technique for the competency though. your teacher will be impressed with your being done in 15 minutes for a 3 hour exam.👍
 
I don't know what school you went to, but you'll find yourself in front of the ethics committee if you try that at mine.
 
well, we guys usually carve the desired tooth from a paraffin sort of wax block... it is pretty easy actually... look at the tooth as a 2D object from each view i.e. labial or buccal, lingual or palatal, mesial, distal and occlusal or incisal... try to get each view of tooth as accurately as possible to the picture of the real tooth in Wheelers or any other reference book. then slowly cut and carve the wax till u get that side of the tooth matching with the image. Start with the crown and at the end do the root(s)...
here we gotta carve each tooth in 45 minutes... and we have to do all the permanent teeth as submissions till the end of the year...
For practice u can start with making easy shapes like a cube, cone etc...

There is a few videos on anatomy of various teeth and how to wax them on my website... check it out...
Dental Anatomy Videos on www.dentalspaces.net
 
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