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Figure 11: The 856-025 bur is the workhorse of the Reverse Preparation Technique. I find this bur extremely easy to cut with because of its coarse grit and wide surface area. As I move the bur mesiodistally, I am doing the facial reduction to the bottom of the depth cut. I am really not doing any reduction in the gingival third. The tip of the bur almost floats in space as I make the facial depth cut and blend it with the gingival. Figure 12: I turn the 856-025 bur perpendicular to the incisal edge and connect the two 2 mm depth cuts I made in Figure 8. As the bur moves mesiodistally, it is pretty easy to make quick work of incisal edge reduction. Because the tip of the bur is pointed at the lingual, I roll the tip of the bur about 20 degrees toward the lingual margin. Figure 13: I now do the lingual reduction using a 379-023 football bur. This bur is convex and cuts a concave surface, which is the shape of the lingual surface of a natural tooth. You don’t really need to place a lingual depth cut because you have the opposing tooth to use as reference, but you could certainly place a 1 mm depth cut here, if you wished. Figure 14: This image explains why I will never switch from an electric handpiece. I am able to turn down the handpiece speed to 5000 RPM, which allows me to turn off the water. Even with the water turned off, I will not generate excessive heat because the bur is only spinning at 5000 RPM. This is the only way I can really dial in and smooth the margins. With the water turned off, it is easy to see what I am doing. 18 www.chairsidemagazine.com
Figure 15: The prep is essentially done. I now place the top cord, an Ultradent Ultrapak Cord #2E. The first cord (#00) retracts the tissue for the prep and also helps ensure we get a slightly subgingival margin. This means we never have to take a bur subgingival, which often causes bleeding. Figure 16: The top cord (#2E) is now placed. This cord is responsible for displacing the tissue laterally, to make room for the impression material. The #2E cord can’t be used in all clinical situations because it is simply too big for many lower anteriors or upper bicuspids with minimal attached tissue. For those cases, a smaller top cord, such as Ultrapak Cord #1, can be used to achieve similar results. Figure 17: With the top cord in place, you have one final opportunity to get a great look at the prep. Typically, I spend about 45 seconds polishing the prep, especially the gingival margin. I again turn the handpiece down to 5000 RPM and the water off, and I use a red-striped fine grit 856-025 bur to give the prep a mirror-like finish. Figure 18: Here is an incisal view of the finished prep. The top cord is in place with just a small tail protruding on the lingual for easy removal. The gingival margin is smooth and uniform all the way around the preparation. This is due to the use of the round bur early in the procedure, when the hard tissue landmarks were still in place. Photo Essay: Anterior BruxZir Solid Zirconia Crown19
Page 1: Chairside® A Publication of Glidew
Page 4 and 5: Contents 38 CEREC ® Connect: A Wel
Page 6 and 7: Letters to the Editor Dear Dr. DiTo
Page 8 and 9: Contributors Michael C. DiTolla, DD
Page 10 and 11: Numbers by the An elephant’s mola
Page 12 and 13: Dr. DiTolla’s CLINICAL TIPS PRODU
Page 14: Dr. DiTolla’s CLINICAL TIPS PRODU
Page 17 and 18: Figure 1: Tooth #9 is going to be p
Page 19: Figure 7: Crowns often look fake in
Page 23: Depth cuts ensure that we get enoug
Page 27 and 28: Interview with Stephen Thorne - INT
Page 29 and 30: ST: No, it was definitely the forme
Page 31 and 32: can share a blog. There are many ti
Page 33 and 34: After those steps, Owner Dentists t
Page 35 and 36: dental schools, and I thought that
Page 37 and 38: all the way through retirement. And
Page 40 and 41: CEREC ® Connect: A Welcomed Upgrad
Page 42 and 43: Many CEREC ® dentists find making
Page 44 and 45: Figure 1 Figure 2 CEREC Connect Pro
Page 46: Figure 5 Figure 6 Conclusion CEREC
Page 50 and 51: working stone model of the single p
Page 52 and 53: detailed occlusal anatomy picked up
Page 54 and 55: high occlusion in the final prosthe
Page 56: use a high-flow, stiff (no bounce)
Page 60 and 61: most overlooked esthetic zone 3,4 (
Page 62 and 63: and floss. The facial and lingual p
Page 64: metal designs like the Wynne Hybrid
Page 67: The Chairside® PHOT Hunt Eleven ye

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