Buildup Technique that works- By Thomas W. Mitchell, DDS, FAGD

Introduction: 

Lots of comments lately about buildups coming off in impressions or in the temporary crowns either when they're fabricated or at the seating appointment. Here's the procedure that Dr. John Kanca taught me. I'm using Clean and Boost, Surpass 1,2,3, WO Titan Flowable and WO Anchor. I have the Valo light set on Standard Setting. John tells me he's using Superb instead of Surpass and Titan instead of Anchor. Neither one of us are have buildups debond.

Thomas W. Mitchell, DDS, FAGD
90+ yo lady in moderate health with a very old gold onlay on #3. The buccal cusps fractured off from the rest of the onlay and there's mesial decay. I quickly put composite over the fractured buccal surface at her recall appointment.
Thomas W. Mitchell, DDS, FAGD
With the crown off we can see the decay and the soft, stained occlusal surface.
Thomas W. Mitchell, DDS, FAGD
Decay removal done and basic prep complete
Thomas W. Mitchell, DDS, FAGD
Clean and Boost applied and washed off to get the surface clean enough for bonding. Then Surpass 1,2,3 and WO Titan Flowable co-cured for 10 secs with the Valo light on Standard Setting
Thomas W. Mitchell, DDS, FAGD
WO Anchor globbed on over the Titan, cured for 10 secs with the Valo on Standard Setting and the prep basically shaped. John has said that now he's using Titan Flowable rather than Anchor for his buildups. I tried that and it's fine. You'll have to add multiple layers and cure each one separately.
Thomas W. Mitchell, DDS, FAGD
The final prep ready for impression. I did have to electrosurg the mesial tissue that had hypertrophied into the decayed area. This buildup made it thru the impression and the temporary fabrication. As long as you've either prepped off the outside layer of the anchor or cleaned it with alcohol it won't stick to the temp material as that sets up. I also have not had these come off when removing the temps at the seating appointment.

Conclusion: 

I know a bunch of you have complained about buildups coming off in the impressions or in the temps. Since I started with this technique I have not had that happen, and I've been doing this since Anchor became Anchor. This is technique sensitive. As long as you follow the instructions as written with the products, as shown on the Apex Dental Materials website, and as shown here, you won't have problems with debonding buildups.

Case by: 

Thomas W. Mitchell, DDS, FAGD