Would you like to make your crown preparations both faster and better? Of course that’s a rhetorical question; every dentist wants both of those. “Better,” of course, should usually trump “faster,” but keep reading to find five tips on achieving both at the same time.
1. Know what you want
By this I mean know how much room you need for whatever material you are using. Notice I said room, not reduction. Read on to see why I said “room” first.
2. Know where you are and where you want to be
Let’s say I want 2 mm of crown thickness, but the occlusal surface of the tooth I am getting ready to prepare is 1 mm below my desired occlusal plane. If that’s the case, I already have 1 mm of room and only need to add another 1 mm; therefore, I will only need 1 mm of reduction. This will then give me the 2 mm of room I want. If we reduced this same tooth 2 mm, we would have 3 mm of room. We would have over-reduced the tooth, which as we all know is something we want to avoid.
(Click this link for more on room versus reduction.)
3. Know your burs
This is where efficiency come in. Pick your burs to make life easy. For instance, if you want 2 mm of reduction, why not use a bur that will let your predictably and accurately remove that 2 mm in one pass without guesswork? The same principle can be applied to your axial reduction. Know the measurements of your burs and how you plan to cut with them to get your desired reduction. If measuring all your burs and designing your own bur block sounds like too much work, then check out these bur blocks from Brassler that Bob Winter designed to do just what I am talking about.
(Click this link for more on dental burs.)
4. Be methodical
The less number of times you change burs, the more efficient you can be. For example, if you are preparing multiple teeth and you are going to use the same bur for all your occlusal reduction, do the occlusal reduction for all of those teeth at the same time.
5. Keep it smooth
Think smooth flowing cuts, especially as you do the margins. After your initial “rough-out” of the prep, go back to refine and polish it. If you are using the right burs and being methodical, your “rough-out” of the preparation is going to be pretty nice to start with. That means you will not do a whole lot of work with bur in the refine/polish phase.
(Click this link for even more on smoother preparations.)
Want to put this all together in a great hands-on workshop to speed up your incorporation of these principles in your own practice? I highly recommend the “Restorative Design” workshop at Spear Education; I promise you will find it very beneficial.
(Click this link for more articles by Dr. John Carson.)
John R. Carson, DDS, PC, Spear Visiting Faculty and Contributing Author www.johncarsondds.com