tips and tricks

During my free time I spent a little while playing around with waxing up anatomy on a set of models which taught me a lot about anatomy and the handling of wax. Below are some tips I thought of at the time: -Use good quality wax. Better quality wax will have the ideal melting properties and strength to allow ease of use and longevity. You don't want the melting point it too high as it will solidify before you place the wax. Too low and it will be too runny and will take too long to solidify making your waxup take much longer. -The model need to be very dry before you wax up onto it or the wax won't stick and will come off with manipulation or the creation of a putty stent -Use fine instruments to place the wax as they are more precise. For a long time I was using a lecron carver because that was all that was available for I trialled using an old, blunt sickle probe with good results. -Set up your work station for maximum efficiency. Keeping your instruments arranged neatly...

I've heard it so many times before where someone says "well it's only the primary impression so it's fine" or "it's good enough". I do take issue with this line of thinking because it raises the question of: When is "good enough" acceptable? I would argue that we should be trying to do the best quality dentistry at every stage of the process or our results will suffer. If our primary impressions are bad, our special trays and planning will be compromised. Inaccuracies carry on down the line. If our cavity preparations are non ideal, our final restorations can't be as good as they can be. Which step is it ok to be bad at? Records such as impressions, bite records, facebows and photos are extremely important. All of the planning occurs based on these records. Planning is the most important part of dentistry because it sets up your appointment sequence, treatment to be done, treatment order. Why do you want to compromise on this most ...

 So I've just finished up with the last viva for the primary exams this year. I thought I'd jot down a few thoughts about the journey while I'm here.   -This year the exams were online which is the first time this has happened. I didn't experience any glitches or dropouts and the process was well organised and streamlined. I don't know how I would have done with a hand written exam as my hand writing is both slow and poorly legible. I found the typing to be a bonus. The program they used for the exams watched you through the webcam and would flag moments that your eyes were away from the screen or you were talking and this would be reviewed by the examiner during marking. -On reflection, last year there were multiple factors that led to my resignation of the exams. Firstly I hadn't paid for them so was studying for the exams without the obligation of actually being locked into doing them. Although I could maintain a heavy level of study, ultimately it gave the a...

I was thinking during a walk today about an impression I had to take a while back where the 18 was very buccally tilted and overerupted. The issue was that the largest impression tray wasn't large enough to get around this abnormally positioned tooth and the tray wasn't seating. During my walk I asked myself what are the possible solutions to this problem. I cam up with a few: 1. Take a bad impression: Take an impression with a very overfilled tray and hope to get enough detail for what you want to achieve. The issue is the material around the 18 is unsupported and is likely to tear when you withdraw the impression, the differences in impression material thickness will result in inaccuracy and the tray seating onto a hard surface will cause rebound of the tray when you remove it resulting in further inaccuracy 2. Soften the tray in a flame and widen the tray around the tooth: This is what I did in the aforementioned situation. I used a bunsen burner to heat the tray in the...

I was thinking about this question in the car yesterday. Many of our guarantees about dentistry lasting for a number of years or giving warranties comes from our own insecurities about our work. The truth is we don't really know. It lasts as long as it lasts. We can identify risk factors associated with early failure such as wear facets, large masseters, plaque accumulation, erosive wear etc and we can take steps to mitigate these risks. Despite this, dentistry lasts only as long as it lasts and we won't know when it will fail until it finally does. The question can be reversed though to: How long are teeth meant to last? The truth is that patients who require complex dentistry have ruined their natural teeth and their dentistry will fail one day too. It begs the question as to why we are designed with such fatal flaws and why we are in need of repair. The truth is that no design is perfect. Our teeth are only one of many things that wear and breakdown over time. Disease is...

Class 1 occlusions are the ideal occlusions discussed in the textbooks but they aren't always present. In fact, the majority of people in the community will be class 2. The occlusal contacts represented as dots and lines in the diagram of the previous part is based on a class 1 occlusion. Class 2 and class 3 occlusions will show different relationships and achieving a class 1 occlusion post treatment is not always possible or desirable when considering the goals of the patient. It is important to know why we do what we do and why the goals of treatment is what they are so that we can bend the rules as needed. The main change with Class 2 and 3 occlusions is the anterior guidance component of the occlusion. distribution of occlusal contacts is possible in any occlusion as the reason why we aim to do this is to reduce the non axial loads through teeth when the muscles are at their highest force. The position of these contacts may change with different positions on the occlusal sur...

Occlusion can be studied to try and improve success or reduce failures. Occlusion isn't a goal but it is a tool that we can use to achieve our goal. Everything fails if given enough time but we are aiming to slow the progress of this down so that the failure occurs as far away as possible. Patients need to understand this risk before agreeing to any treatment. Dental materials excepting fracture from trauma tend to break after repeated cyclic fatigue. The management of occlusion aims to reduce the force on teeth and restorations to reduce cyclic fatigue failure. This aim is independent of the materials used. Be it LiSi, zirconia, gold, base metal, composite, amalgam, enamel or dentine they will all fail if loaded enough for enough time. Materials that claim extrordinary strength such as some zirconias have the trade off of being very brittle. On the other hand, materials that are softer such as gold will burnish under high load, adapt to the conditions and therefore is less likel...