Bonding Some Badly Broken Down Teeth- By Dr. C. Terrence Shaw (DocTerry)

Introduction:

21 year old young lady with some badly decayed teeth needing numerous restorations. I restored her anterior teeth in 2 sessions 2 weeks apart. I could see a large improvement in her hygiene in the 2 weeks between appointments. Pleased about that!!

Lots of decay and poor home care.

Teeth together. MI.

Incisal view.

Most of the decay has been removed from centrals and left lateral.

I then removed some puffy gingiva from around her teeth for better vision and isolation. I use my "laser" bur -- a 7901 carbide - works well and costs 5 bucks!! Laser costs a little more.

A minute later you can see more bleeding around the gingiva.

2 minutes later with rubber dam in place and 90N clamp on right central I am ready to start restoring her teeth.

Ready to restore. Cure thru matrix in place.

I did the mesial and distal separate for more control and less finishing later.

First day's work.

2 weeks later and gingiva is looking much better!!!

Right canine.

Tooth etched -total etch and dried 3 seconds. Collagen fibers have collapsed!!!

Bondsaver D has been applied to rewet the collagen fibers and stand them up so I can infiltrate my primers around them and get a hybrid layer. Bondsaver is from Dr. John Kanca and is supposed to provide maximum dentin bond strength for ever!!!!! Or till I retire in a few more years!!! Check Apex Dental Materials, Inc. for more information.

Primers applied. I have used Bondsaver D for a week and will say it makes it much easier as I don't have to watch nearly as closely when I dry after etching and worry about over or under drying before applying my primers. I simply dry after etching for 3 seconds and apply Bondsaver D and rewet my dentin and in 5-10 seconds add my primers to a correctly wetted dentin surface. Nice!!!

Resin bonding plus composite added.

Composite all added.

Lateral.

Polished with a 3M Soflex disk.

From here

to here. Probably 3 hours operative time and 2 weeks between appointments. Still work to do after Xmas when her dental plan re-energizes itself in the next calendar year.

Conclusion:

It was nice to see this young lady improve her hygiene and hopefully keep her teeth for many more years.

Case by:

C.Terrence Shaw, BSc, DDS

Email:

dkdocterry@gmail.com