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Figure 5: As often happens, the tissue underneath the pontic was
chronically irritated and bleeding from being hit with water spray. Patients
can tell you they use a floss threader nightly, but the truth is always
revealed when the pontic is removed. Viscostat ® (Ultradent Products;
South Jordan, Utah) is used to keep things clean and dry.
Figure 6: A plain Ultrapak ® 00 cord (Ultradent Products) is “flossed” by
hand on the mesial and distal, leaving a small amount of cord on the
facial. I use a straight, non-serrated cord packer to place the cord in the
sulcus on the facial. The two ends of the cord are cut on the lingual so
they will sit flush in the sulcus.
Figure 7: Once the 00 cord is packed, it should disappear into the base
of the sulcus. We then move on to the next step of the Reverse Preparation
Technique. The 801-021 round bur is used to half its depth to ensure
adequate gingival reduction, and we cut the initial margin at the same
time. This technique leads to simple, beautiful and consistent margins.
Figure 8: The next step of the Reverse Preparation Technique is the
incisal edge depth cut. Because we are going to restore these teeth to
the length they are now, we need to reduce 2 mm in order to give our
technicians room to create a natural incisal edge. This 2 mm depth cutter
is self-limiting to ensure you don’t overprepare.
Restorative Photo Essay: The IOS FastScan and an Anterior BruxZir Bridge17