26/09/2022
‘Classic’ prosthodontic solution for providing torsional stiffness to the abutment teeth with significant clinical attachment loss. 41 was lost through 2021 lockdown and the remaining anteriors have grade 1-2 mobility. This anterior segment has been periodontally stable for many years, except during the lockdown period. The concern is that a direct bonded resin approach (unless very thick, includes fibreglass or a metal wire) will be under constant torsional load and not provide durable rigidity. Also note: often patients are unaware that a tooth has debonded off a retainer and it is only found at the following dental appointment.
A lingual bonded Maryland bridge would debond in the same way too. Modification: 0.7mm axial slots were added to the proximal surfaces to improve the retention and resistance form of the bridge. Slots were quite parallel, so parallel that the ceramist took 5 pours to get a working model. I don’t intentionally want to make people’s life difficult. She has many years of experience and said that she believed she’d never ever see pin and slot preparations after graduating
26/09/2022
‘Classic’ prosthodontic solution for providing torsional stiffness to the abutment teeth with significant clinical attachment loss. 41 was lost through 2021 lockdown and the remaining anteriors have grade 1-2 mobility. This anterior segment has been periodontally stable for many years, except during the lockdown period. The concern is that a direct bonded resin approach (unless very thick, includes fibreglass or a metal wire) will be under constant torsional load and not provide durable rigidity. Also note: often patients are unaware that a tooth has debonded off a retainer and it is only found at the following dental appointment.
A lingual bonded Maryland bridge would debond in the same way too. Modification: 0.7mm axial slots were added to the proximal surfaces to improve the retention and resistance form of the bridge. Slots were quite parallel, so parallel that the ceramist took 5 pours to get a working model. I don’t intentionally want to make people’s life difficult. She has many years of experience and said that she believed she’d never ever see pin and slot preparations after graduating!
07/06/2022
5-year recall of 4x lower posterior restorations Tokuyama Estelite Sigma Quick
As a recent grad I was asked if I’ve ever seen my work fail, or whether I’ve stayed in a practice long enough to see my work fail. Definitely a hard question to answer truthfully as a new grad. Practice dentistry the way that others before me have demonstrably shown, evidence à l’appui to give maximum longevity
03/05/2022
Read this case as a “what actually happens down the track” when you recommend to a patient to leave a root behind, or perhaps an uninstrumented canal etc.
There was an attempt to remove the 15 some years ago and one of the roots (if not the one and only root) fractured. The exodentist at the time was hesitant to complete the procedure and perhaps recommended that he sees a specialist to complete it. I truly don’t know what the actual conversation was at the time, but some time had passed and being asymptomatic, a bridge was placed, knowing that that root was being retained.. and see how you go.
Fast forward to 4-5 years later, patient has cancer, starting chemotherapy, is about to get surgery in a couple of weeks and comes in for a hygiene appointment and has suppuration under the anterior abutment. No one wants to carry with them an intra-oral draining infection in an immunocompromised state and about to be intubated for a general anaesthetic procedure. Yes the procedure was uneventful and I didn’t have to remove bone as it was biologically done already, but you can easily picture tricky extractions while a bridge is present.
So if you want to place a bridge… maybe think about the consequences of not removing any retained roots
22/04/2021
Solution to a dry jar of cavit is to add acetic acid
01/09/2019
I don’t have a pre-prep photograph because I didn’t expect to see caries in this form! I started with an occlusal prep and I almost always prep through the remaining fissure for multiple reasons. Here’s one. Have a look at the floor of both the occlusal and palatal fissures at depth and they actually connect, actually have caries and if you were to have only done the occlusal part.. you would have restored your prep with caries left behind from day one. It’s not so simple to be conservative @ Melbourne, Victoria, Australia
22/08/2019
Ain’t going to lie here, I graduated being taught to handle resin to dentine bonding with extreme prejudice. FFWD to 2019 and nothing has changed from the faculty. It’s as if the program was verbatim 2000s era. I promise to show you right side of bonding one meme at a time
18/08/2019
Hello! Ouch! With multi-rooted teeth, the pulp can be partially necrotic and partially vital. Or is it a pulp that is both necrotic and vital? Hmm a biological Schrödinger’s paradox! Noticed the cracked tooth? It didn’t look bad for quite some time and suddenly 🤯 if you saw a cracked tooth that is asymptomatic, what would and what should your thoughts be? @ Melbourne, Victoria, Australia
22/07/2019
Sorry for the clipping. Important lesson about confidence and perception. It started as a joke page. Question on the page was “st what moment in your career did you stop thinking like this?” Swipe for my answer and a response. What do you think? Swipe again for the psychological basis for my answer. My aim is to get you off that new grad peak ASAP. Join me :) @ Melbourne, Victoria, Australia