Sealing Crown Preps Prior to Temporary Placement- By Thomas W. Mitchell, DDS, FAGD

Introduction: 

Many of us like to seal our preps with our bonding resin to prevent post op sensitivity and to increase retention of bonded restorations and restorations cemented with RMGI's. This is my protocol.

Thomas W. Mitchell, DDS, FAGD
This is obviously not one of my crowns, but unfortunately we all do see this junk.
Thomas W. Mitchell, DDS, FAGD
I like to slice crowns and peal them off the prep like pealing an orange.
Thomas W. Mitchell, DDS, FAGD
This is after decay removal and before the buildup. My current buildup protocol is Clean and Boost for 20 secs, wash/dry, Bond Saver D allowed to dwell for 5-10 secs and leave the prep wet - only dry enough to remove any puddles, 3 coats of Surpass 2, dry for 10 secs, a thin coat of Surpass 3 (air thin) and co-cure Titan WO Flowable for 10 secs with the Valo on Standard power, then "bulk fill" with WO Anchor and cure immediately for 10 secs. Then complete the prep. I rarely wait for the dual-cure Anchor to reach it's gel stage before adding light in this situation.
Thomas W. Mitchell, DDS, FAGD
Then we finished the prep and made the temporary and, for this case, took the final impression before sealing the prep.
Thomas W. Mitchell, DDS, FAGD
Then Clean and Boost, wash/dry, Bond Saver D and leave wet, 3 coats Surpass 2 and dry, then a very thin coat of Surpass 3 (air thin completely) and cure from each direction. Then I scrub off the oxygen inhibited layer with alcohol and cement the temp.

Conclusion: 

Over time the protocol for bonding has evolved. Originally we were cleaning the prep with alcohol, then adding Surpass 1,2,3 and curing. Then we added co-curing Titan flowable to speed up the procedure, toughen up the bond, and to eliminate that radio opaque line under the restoration. Then the alcohol used as a cleaner was replaced with Clean and Boost, which eventually replaced Surpass 1. Now we have Bond Saver D to help with desensitizing and to protect the integrity of the dentin bond. Bulk filling and pulse curing with Exquisite have also evolved.
The original protocol with only Surpass 1,2,3 including co-curing the flowable gave fabulous results. So that's a great way to go. If you want to be "cutting edge", then the protocol outlined above is available for you.

Case by: 

Thomas W. Mitchell, DDS, FAGD

Email: 

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