The Effect of Rubber Dam Isolation on Bond Strength to Enamel 

March 13, 2024 Christopher Mazzola, DDS

Christopher Mazzola, DDS 

This is an example of a clinical study that can help us in our everyday practice of dentistry. Although the findings do not surprise us, keeping the findings in mind will guide us in decisions we make when performing treatments our patients are counting on to be long lasting. 

Dr. Markus Blatz is co-founder and past President of the International Academy for Adhesive Dentistry (IAAD) and Chairman of the Department of Preventive and Restorative Sciences and Assistant Dean for Digital Innovation and Professional Development at the University of Pennsylvania School of Dental Medicine in Philadelphia. He and a research team from the University of Coimbra, in Portugal, studied the effect of rubber dam isolation on bond strength to enamel. Their goal was to test two hypotheses. 

Hypothesis 1: Rubber dam isolation improves sheer bond strength independent of the adhesive system used. 

Hypothesis 2: A highly filled 3-step etch and rinse adhesive will provide higher bond strength values than an isopropyl-based universal adhesive. 

For their tests, they used OptiBond FL from Kerr for the 3-step etch and rinse adhesive and Prime & Bond Universal Adhesive for the isopropyl-based universal adhesive. 

The mesial, distal, lingual, and vestibular enamel surfaces of thirty human third molars were prepared (total n = 120 surfaces). A custom splint was made to fit a volunteer’s maxilla, holding the specimens in place in the oral cavity. Four composite resin cylinders were bonded to each tooth with one of two bonding agents (OptiBond FL and Prime & Bond) with or without rubber dam isolation. Shear bond strength was tested in a universal testing machine and failure modes were assessed. 

Both hypotheses were supported by the results reported in the Journal of Esthetic and Restorative Dentistry in November of 2022. 

  • With the rubber dam in place, both of the adhesives performed better than without the rubber dam in place, resulting in approximately twice as much shear bond strength with the rubber dam. 
  • The 3-step OptiBond FL system resulted in a more resilient bond than the Prime & Bond Universal adhesive. The OptiBond FL group with rubber dam presented the highest mean bond strength values. Fracture modes for specimens bonded without rubber dam isolation were adhesive and cohesive within enamel, while rubber dam experimental groups revealed only cohesive fractures. 

For the benefit of our patients, we shouldn’t cut corners that will impact the longevity of a restoration. My thoughts are that whenever we have basic pure enamel bonding it should be under a rubber dam, using a total etch, 3-step adhesive system. But considering dentin likes to be moist, we may need to make other clinical judgments.  

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DATE: October 24 2025 @ 8:00 am - October 25 2025 @ 2:30 pm

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CE HOURS: 15

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Christopher Mazzola, DDS

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The Pre-Clinical Interview – Part 2 

March 11, 2024 Laura Harkin

Laura Harkin, DMD, MAGD 

Let’s delve deeper into the preclinical interview! 

It’s helpful to understand a patient’s perception of their overall health and oral health, as well as what type of restorative dentistry they’re hoping to have and why they feel the way they currently do.  

Sometimes, an integral family member has influenced the timing of care. For instance, you may hear, “My grandchildren are making fun of my teeth” or “My wife asked me to get my teeth fixed.” From this response, I know that I will need to be sure my patient personally desires treatment before rendering it. I’m also anxious to understand what type of restorative dentistry a patient is considering. For example, are they open to removable prosthetics, fixed crown and bridgework, or implantology? 

Recently a new patient came to my office with an emergency. Tooth #5 presented with the buccal wall broken to the gumline and a moderate-sized, retained, amalgam filling. He immediately said, “I do not want bridgework.” I listened quietly until he elaborated by saying, “When I had this front tooth replaced by my other dentist, I had to take it in and out, and I just found that so irritating.”  

I finally understood that he was referring to a flipper but calling it bridgework. So, it’s important to listen and ask questions when someone seems close-minded about having a certain modality of treatment. Delve deeper into the conversation because it may simply be confusion surrounding dental terminology. 

For the grandparents who ask for a better smile, I’d like to understand their thoughts on the scope of treatment and their expectations. Are they looking for a white, straight, Hollywood smile or a more natural appearance with a little bit of play in the lateral incisors? Are they mainly concerned about stains, gaps, or a missing tooth? Are there other problems they’re aware of such as tooth sensitivity, inflamed gums, or the need for a crown? This input is very important as we continue conversation with co-discovery throughout the clinical exam, diagnostic records, and treatment planning phase. 

Learn to count on your chairside for pertinent information. 

I’m fortunate to always have my assistant, Cindy, beside me for preclinical conversations, comprehensive examinations, and restorative procedures. Sometimes, Cindy interprets a patient’s statement or component of conversation differently than me. She may hear a message that I missed or read body language of which I wasn’t aware. Sometimes, auxiliary conversations between patient and assistant take place after I’ve left the room to complete a hygiene check.  

At the end of the day or in the morning huddle, we always take time to discuss interactions with our patients. Together as a team, we’re more efficient at acquiring accurate information so that we may approach the road to health most effectively for each individual. 

Determine if trust is present. 

As I’m getting to know a patient and before I choose to begin restorative treatment, I seek to understand if trust is present in our doctor/patient relationship. New patients often share past dental experiences, and, unfortunately, some have lost trust in dentistry itself. This may be warranted due to improper care, but it may also be due to a lack of understanding or unclarified expectations regarding a given procedure or material choice.  

It’s not unusual, particularly when a patient is considering a large scope of treatment, to serve as a second or third opinion. Building trust and waiting to be asked for our skills are key necessities before moving forward in irreversible therapy.  

The comprehensive examination, periodontal therapy, splint therapy, and gathering of records are all appointments during which opportunities exist to get to know our patients. True trust often takes time to establish, but the reward reaped is frequently one of empathy, friendship, and the ability to do our best work. 

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Laura Harkin

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A Tip for Matching the Color of Cement Between an Implant Abutment and Crown

March 8, 2024 Lee Ann Brady

Trying to match the color of the cement between the abutment and the dental implant crown in the anterior can be very frustrating. Here’s a trick that works well for me. 

A while back I was struggling to match the color of the cement between the abutment and an anterior implant crown. I always try-in the abutment and the crown and try to confirm the shade before they are put together. We do this because the laboratory can’t redo the shade once they’ve bonded the crown and the abutment for screw retention without trying to separate the cement, which is difficult. 

Over the years, it was a challenge to replicate the opacity of the cement used to connect the titanium abutment and ceramic crown. I’ve tried using some of the opaquest try-in paste on the market. 

In the case I referred to above, we thought we had it. My lab cemented it together and I put it in. I could see the opacity of the cement through the restoration. So, we had to take it apart and try again. My laboratory technician shared with me a trick that he had learned from one of his other dentist clients. And that was to simply go to CVS, Costco, or Target and buy good old fashioned liquid white out.  

Now, I put a very tiny amount of whiteout on a micro brush and paint it on the inside of the labial surface of the crown on the intaglio surface. Then, I use a bit of translucent try-in paste to seat the crown. 

The whiteout works well because it is basically titanium dioxide and water with preservatives—the same white compound that is in super white sunscreens. In my opinion, it is relatively safe to use, and I can see what the implant will look like when the pieces are cemented together. 

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Worn Dentition: Direct & Indirect Adhesive Management Through a Non-Invasive Approach

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How Ivoclean Works 

March 1, 2024 Lee Ann Brady

How Ivoclean Works 

Lee Ann Brady, DMD 

Saliva on the inside of restoration surfaces greatly reduces the bond strength between the porcelain and the cement but during the intraoral try-in process, it is inevitable that there will be saliva contamination. 

Most dentists I know use Ivoclean from Ivoclar to clean their indirect restorations after try-in. It is an incredible material for removing saliva and other contaminants that the restoration is exposed to during the intraoral try-in process.  

We trust Ivoclean to fully remove resin or traditional cements, as well as saliva and red blood cells to produce a super pristine surface.  

Did you ever wonder how Ivoclean works to get rid of saliva and all the other debris that gets on the inside of a ceramic restoration or metal base?  

Intraoral contaminants contain lots of phosphates. Ivoclean contains suspended zirconia particles that have an affinity for phosphates. The zirconia particles pull towards them the phosphate-laden particles, so when you rinse off the Ivoclean, the intraoral debris is rinsed away leaving a clean surface. 

Note: We don’t want to expose zirconia restorations to something that contains phosphates or includes phosphoric on the label because there is a strong attraction at an elemental level between zirconia and phosphate particles. To neutralize the ionic bond between saliva phosphates and zirconia, we need an alkaline solution such as potassium hydroxide (KOH). This is the active ingredient in products such as ZirClean from BISCO. 

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Lee Ann Brady

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Dental Sleep Medicine in Restorative Practice Part 9: Marketing Dental Sleep Medicine 

February 28, 2024 Todd Sander, DMD

Dental Sleep Medicine in Restorative Practice Part 9: Marketing Dental Sleep Medicine 

By Todd Sander DDS 

How do you start reaching out to physicians and other providers to build a dental sleep medicine practice? Start with the ones you know. Start with your own personal physician and start a conversation. If your dental patient is on CPAP, get permission to converse with their doctor. I spend time contacting many primary care doctors and find they are the ones who know patients are non-compliant with their CPAP therapy. They help me get patients re-evaluated by a sleep specialist. 

This may not be true in your community, but in Charleston, SC, where I practice, many primary care doctors don’t know what to do with their non-compliant CPAP patients. They are thrilled to have someone to refer them to try alternative therapy. 

Years ago, I reached out to sleep testing centers to communicate my services. Both independent sleep labs and hospital-based sleep labs have been great sources of referrals. For many years, I was the dental advisor to a sleep lab. A great conversation starter with sleep physicians, is the potential of combining CPAP and an oral appliance. This often allows the CPAP air pressure to be turned down so their patients be more comfortable and compliant. 

When you screen your dental patients for airway issues such as sleep apnea and snoring, the next step is referring your patients with issues for a sleep study. When the patient discusses their symptoms with their primary care physician or a sleep physician, you are mentioned and often documented as making the referral. Over time, physicians come to know you as a go-to provider of dental sleep appliance therapy. This process is sped up when you take the time and initiative to contact your patient’s primary care physician with your patient’s permission. You can guide physicians and remind them of the recommended standards-of-care, including appliance therapy in place of or in combination with CPAP therapy. 

Some patients self-refer to me, as friends and family talk about their experiences in my office, but I am not spending money on digital advertising to bring in dental sleep medicine patients. Mostly, they are referred to me by physicians, dentists, and other patients.  This is the same for my dental practice. 

As mentioned in a previous part of this series, our hygienists have attended dental sleep medicine courses with me and screen for airway issues. They adeptly educate and guide patients who have signs and symptoms to schedule an examination and consultation with me. 

Note: When patients are referred to me for dental sleep medicine, I never encourage them to become dental patients in our practice. This is a choice they might make but I am extremely careful to refer patients referred by a dentist back to their referring dentist for all dental needs. I am an adjunct to help other dentists’ patients fulfill a prescription for a dental appliance. 

If a patient comes in for sleep-disordered breathing but is also experiencing facial pain or TMD, I understand that this patient’s two issues are likely connected and I will not be able to successfully treat one without treating the other. This is an opportunity to communicate in depth with the referring dentists and let them know I plan to treat the patient for both issues simultaneously. This has been easier for me to do because I have had years of experience in treating facial pain and TMD issues in my dental practice, as well as sleep apnea and snoring. 

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Todd Sander, DMD

Dr. Todd Sander is a graduate of The University of North Carolina at Chapel Hill, the School of Dentistry at Temple University, and a one-year Advanced Education in General Dentistry residency with the US Army at Fort Jackson, SC. He completed three years of active duty with the US Army Dental Corps and served in Iraq for 11 months. Dr. Sander completed more than 500 hours of postgraduate training at the Pankey Institute for Advance Dental Education and is one of only three dentists in the Charleston area to hold such a distinction. Dr. Sander is also affiliated with the American Dental Association, South Carolina Dental Association, American Academy of Cosmetic Dentistry, Academy of General Dentistry, and American Academy of Dental Sleep Medicine. Areas of special interest include: TMJ disorders; advanced dental technology; cosmetic dentistry; full mouth reconstruction; sleep apnea /snoring therapy; Invisalign orthodontics.

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Restorative Notes on Bonding to Sclerotic Dentin and Removing All-Ceramic Crowns

February 7, 2024 Lee Ann Brady

Restorative Notes on Bonding to Sclerotic Dentin and Removing All-Ceramic Crowns 

By Lee Ann Brady, DMD 

Bonding to Sclerotic Dentin 

Bonding to sclerotic dentin is difficult, if not close to impossible. If the lion’s share of the tooth’s surface is sclerotic, you may not have the longevity that you’re hoping for. I’m specifically thinking of some lower anterior restorative cases I’ve seen over the years, where the veneers just haven’t held up and we’ve had to go to full coverage. 

I don’t trust some of the self-etching adhesives to result in a strong bond on sclerotic dentin, even the newer ones in the eighth generation. Fortunately, one thing we don’t need to worry about is sensitivity because the dental tubules are closed. Since I’m not worried about sensitivity, I can apply the same techniques I would with enamel with the intent of improving the probability of a strong bond. I can do a light prep, get rid of the sclerotic surface, and etch it with phosphoric acid for 25 or 30 seconds. Alternatively, I can use 30- to 50-micron aluminum oxide in an abrasion unit.  

Removing All-Ceramic Crowns 

Removing dental crowns can be a delicate and time-consuming procedure. In a world of so many different materials, it’s helpful to have an idea of which bur to use and how long removing the crown could take. One of the biggest challenges is determining whether a crown is a lithium disilicate or zirconia restoration. The radiograph and visual inspection will give us clues but afterwards, we must go through a process to understand what may be involved. 

Our First Clue: Zirconia looks like metal on a radiograph, and lithium disilicate looks radiolucent like natural tooth structure.   

Our Second Clue: If the crown is partial coverage, it’s much more likely to be bonded and I plan to prep down the entire restoration.  

Lithium disilicate restorations are often easier to cut through or section but they could be bonded and impossible to remove in pieces. Even if we can cut four pieces, we may have extensive prepping to do.  

On the other hand, zirconia can be harder to cut through, especially the 3y or 4y variety. But at least once you get to the cement layer, you can normally break it into pieces and remove them instead of having to extensively prep the entire tooth.  

If the restoration is full coverage, I can easily remove it in sections. In this case, I attempt to make my cuts all the way from buccal to lingual across the occlusal surface without bothering to stop. At this stage, I can pick up a crown remover and apply some general pressure to crack it off. If the crown is not budging at all, I assume it is bonded to the tooth, and the next thing I do is pick up a big flat-top diamond to do my occlusal reduction as if I were prepping a natural tooth. Once all the occlusal is off the glass, the pieces on the buccal, lingual, and interproximal fall off. 

 

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DATE: October 24 2025 @ 8:00 am - October 25 2025 @ 2:30 pm

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CE HOURS: 15

Dentist Tuition : $ 2595

Single Occupancy with Ensuite Private Bath (per night): $ 345

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Adhesive Management of Worn Dentition Using the “Index Technique” The DIRECT Approach

January 23, 2023 Riccardo Ammannato, DDS

The goal of treating severely worn teeth is to extend the life and function of the teeth while improving their function and aesthetics. For the patient’s optimal comfort and health, we seek to achieve a stable posterior occlusion and efficient anterior guidance.

This article is written for the purpose of inspiring dentists to learn indicators for using this technique, and the no-prep “index technique” of diagnosing and restoring worn teeth with composite restorations.

The Benefits of the Index Technique

Conservation of the natural tooth structure—Whenever possible, dentistry should be additive, not subtractive-additive. The adhesion of composite resin is now so reliable that retentive cavity preparations are not always necessary. The digital index technique protocol proposes a conservative and alternative approach based mainly on minimally or noninvasive copy-and-paste composite restorations on both ante¬rior and posterior teeth. In anterior sextants with undercuts, a direct molding technique allows the clinician to be extremely conservative.

Simple repair—Another positive trait of this technique is the relative ease with which chipping or restorative failure can be managed by applying a simple adhesive protocol. Full loss or detachment of the restoration is an unlikely occurrence. Partial failure can be easily repaired with fresh composite following proper surface treatment: sandblasting, salinization, and bonding all surfaces.

Less clinical time and expense—This technique shortens the time to finalize a case. The technique requires a wax-up for planning the case and the fabrication of a transparent index but no other digital or analog lab expense. (See accompanying images above.) With this technique, you can avoid or postpone a more biologically invasive and financially costly solution.

Long-lasting aesthetics—Nano hybrid composite has good wear characteristics. Its superficial gloss lasts, and the composite can be easily repolished during patient re-calls.

Reversibility—With the index technique, you can remove the composite to restore the patient’s teeth to the occlusion they had before treatment if necessary. It should be noted that it is not easy to remove composite after adhesion due to bonding strength and composite chromatic integration with the natural tooth.

Join me for “Worn Dentition: Direct & Indirect Adhesive Management through a Non-Invasive Approach

In October 2023, I will present an in-depth, two-day workshop at The Pankey Institute. During this workshop, you will learn the indications and protocols for diagnosing and treating severely worn dentition using the new direct “Index technique” approach. The course also will cover when and how to bond on worn dentition using additive partial indirect restorations (onlays/overlays) in composite and/or ceramic. The step-by-step protocols for digital and analog workflows will be addressed during the workshop through step by step images and videos on patients in order to understand this “hybrid approach”. I look forward to being back at the Institute, and I hope you will join me there!

The photos below refer to an INDIRECT additive adhesive ceramic cementation case:


while these photos refer to a DIRECT additive adhesive molding copy&paste protocol through the “Index Technique” protocol:


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Riccardo Ammannato, DDS

Graduated at Genoa University (Italy) Internship at the Department of Operative and Restorative Dentistry, University of Zurich under the guidance of Prof. F. Lutz; studying adhesive dentistry and its applications in operative and prosthetic dentistry. Teacher at University of Rome Tor Vergata (Italy), for the year 2017, in Restorative and Esthetic Dentistry. Direct by Prof F. Mangani. Active Member of the European Academy Esthetic Dentistry (EAED); Active Member of the Italian Academy of Operative AIC (Accademia Italiana di Conservativa) since; Active Member of the Italian Academy Esthetic Dentistry (IAED). He has developed and published in 2015 and 2018 on the International Journal of Esthetic Dentistry (IJED), a new and no prep approach to restore worn dentition: The “Index Technique” Author of articles on adhesive and restorative dentistry and speaker in international courses and congresses. He currently practices at his office in Genoa, with multidisciplinary approach, but focusing on esthetics and restorative dentistry.

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Not Every Endodontically Treated Tooth Needs a Crown

August 22, 2022 Lee Ann Brady DMD

Not every tooth that has been endodontically treated requires a crown to insure it has great longevity and doesn’t crack or fracture.

Molars

Very clearly the literature supports that molar teeth in the posterior absolutely must have four cusp coverage—a four-cusp onlay or a full coverage crown. We are trying to use the phenomenon of containment with strong ceramic or metal material around the entire circumference of the tooth. We are holding the buccal and lingual together and replacing the top of the root chamber, so the tooth doesn’t fracture.

Bicuspids

Bicuspids that have been endodontically treated do not need two-cusp coverage if there have been no previous restorations and the endo access is very conservative. In the case of a premolar that has never had an MO, a DO, or an MOD, and has a tiny access hole, you can do a composite buildup or chamber retaining composite restoration. If the patient has high functional risk, a reasonable decision would be to restore the tooth with an onlay or crown

Anterior Teeth

There is no scientific support for doing a crown on an anterior tooth just because it has had endodontic therapy. We do a crown on an anterior tooth that has had endo when it is already structurally compromised, for example with previous mesial lingual and distal lingual composite fillings, missing tooth structure, and significant structural compromise between the endo access and other restorations.

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E1: Aesthetic & Functional Treatment Planning

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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4 Questions You Should Be Able to Answer To Improve Your Success With Indirect Bonded Anterior Restorations

August 16, 2021 Abdi Sameni

Restorations are the foundation of a thriving dental practice because they keep you challenged and motivated while ensuring patient satisfaction. Indirect bonded anterior restorations provide patients with functional and aesthetic solutions to improve their smiles.

But “veneers” are more complicated than they seem when you see the finished product: bonded anterior restorations.

Before you decide on the type of restoration you are going to offer your patients in the anterior region, here are four questions you should be asking to get the most from your restorative process:

  1. Can indirect bonded anterior restorations strengthen worn-down, eroded, or chipped teeth?
  2. Should teeth be whitened before they are veneered?
  3. Should endodontically treated teeth be veneered?
  4. Are crowns stronger than veneers?

If you are hungry for more guidance on indirect bonded anterior restorations, check out my upcoming course at Pankey Online. On Friday, August 20th, 2021, from 2-4 pm ET, I will be hosting a live, 2-hour virtual course, “Indirect Bonded Anterior Restorations.” You can easily register for my course, which provides 2 CE credits, at Pankey Online.

Join me as we discuss useful concepts like three-dimensional functional and esthetic mock-ups, provisional fabrication, preparation design for adhesive restorations, and more. See you there!

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Abdi Sameni

Dr. Abdi Sameni, Clinical Associate Professor of Dentistry at Herman Ostrow School of Dentistry of USC, is the founder and developer of the “International Restorative Dentistry Symposium, Los Angeles.” He is a former faculty for the “esthetic selective” and the former director of the USC Advanced Esthetic Dentistry Continuum for the portion relating to indirect porcelain veneers. Dr. Sameni lectures nationally and internationally. He is a member of The American College of Dentists, OKU National Dental Honor Society and the Pierre Fauchard Academy. Dr. Sameni maintains a practice limited to restorative dentistry in West Los Angeles, California and the 2020 Pankey Institute webinar he presented on interdisciplinary treatment planning can be viewed here on YouTube.

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Polishing Indirect Preparations

August 6, 2021 Lee Ann Brady DMD

The question of whether it is better to have a rough or smooth tooth preparation for indirect restorations pops up from time to time, and dentists relate to me they have heard conflicting opinions.

I go to the research literature to become better informed when questions arise, and this is one question research has answered convincingly for me.

What is the impact of texture on the predictability of your restorations?

When we think about the surface texture of a tooth preparation, there are two considerations.

  1. How does the surface texture have an impact on bond strength or retention of an adhesively placed restoration? Do coarser surface textures on preps increase bond strength, or is it exactly the opposite?
  2. How does the surface texture impact the accuracy of a VPS or Polyether impression and therefore the fit of the restoration?

It turns out that smoother is better.

If you go to the literature and look up the research studies in PubMed, you will find there is a high correlation between high bond strength and extremely smooth surface texture. To achieve an extremely smooth surface texture, multiple studies used carbide burs that are in the same shape that we use in doing crown and veneer preparations.

The other piece of the puzzle (the second consideration) has to do with the contact angle of VPS or Polyether impression materials and the tooth preparation. The smoother the preparation surface is, the more accurate the impression will be. The more accurate the impression is, the more accurate the die will be. And the more accurate the die is, the more accurate the fit of the final restoration will be.

So, in both categories, bond strength for adhesives and accuracy of physical impressions, smoother preps win over coarser preps.

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THIS COURSE IS SOLD OUT Understanding that “form follows function” is critical for knowing how to blend what looks good with what predictably functions well. E3 is the phase of…

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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