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!!

C.Terrence Shaw, BSc, DDS
Lots of decay and poor home care.
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
Teeth together. MI.
C.Terrence Shaw, BSc, DDS
Incisal view.
C.Terrence Shaw, BSc, DDS
Most of the decay has been removed from centrals and left lateral.
C.Terrence Shaw, BSc, DDS
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.
C.Terrence Shaw, BSc, DDS
A minute later you can see more bleeding around the gingiva.
C.Terrence Shaw, BSc, DDS
2 minutes later with rubber dam in place and 90N clamp on right central I am ready to start restoring her teeth.
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
Ready to restore. Cure thru matrix in place.
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
I did the mesial and distal separate for more control and less finishing later.
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
First day's work.
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
2 weeks later and gingiva is looking much better!!!
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
Right canine.
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
Tooth etched -total etch and dried 3 seconds. Collagen fibers have collapsed!!!
C.Terrence Shaw, BSc, DDS
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.
C.Terrence Shaw, BSc, DDS
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!!!
C.Terrence Shaw, BSc, DDS
Resin bonding plus composite added.
C.Terrence Shaw, BSc, DDS
Composite all added.
C.Terrence Shaw, BSc, DDS
Lateral.
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
Polished with a 3M Soflex disk.
C.Terrence Shaw, BSc, DDS
C.Terrence Shaw, BSc, DDS
From here
C.Terrence Shaw, BSc, DDS
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