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Dr. DiTolla's Clinical Tips

Article by Michael C. DiTolla, DDS, FAGD

Product: TempBond Clear™
Category: Dual Cure Resin-Based Cement
Source: Kerr Corporation
Orange, CA
800-537-7123
www.kerrdental.com

Many of us tend to take temporary cements for granted, but I will always remember the first time I realized I need more than one. I had just placed some anterior temporary crowns on a patient with a typical temporary cement that happened to be yellow. And right through the chairside temps my assistant had made, I could see the outline of the preps staring back at me. I was horrified! The temps were a little thinner than usual and the yellow temp cement was showing through. I explained to the patient what was happening and promised I would figure out a solution as soon as I could. Two phone calls later a dentist friend told me about TempBond Clear, and today I would not practice esthetic dentistry without it. Whether it's temps that end up being a little thin after reshaping them, or underneath thin temporary veneers, having a translucent temporary cement is critical. It also works well for inlays and onlays, and since it is a resin-based cement it is dual-cured as well (Image 1).


Product: CeraGlaze® Ultimate Porcelain Polishing Set (RA/Latch) - LS-506
Category: Porcelain Polishing Logic Set
Source: Axis Dental
Coppell, Texas
800-355-5063
www.axisdental.com

Nobody knows more about how to effectively smooth porcelain than your dental laboratory. Oddly enough, dentists don't seem to consult with their laboratories when it comes to polishing ceramic materials. Most dentists think if they send a restoration back to their lab for "reglazing" that the lab will paint on the glaze and run it back up in the oven. The truth is there's too great a risk that the restoration will fracture when this happens, and the lab is able to achieve nearly identical results with polishing wheels. We use the CeraGlaze Ultimate Porcelain Polishing Set here at the lab, and the key is that we use it in a high torque electric handpiece. Polishing ceramics outside of the mouth is an easy enough task, but it becomes more difficult when it needs to be done post-cementation. With my KaVo ELECTROtorque handpiece and the different shapes in the CeraGlaze Logic Set, there is no area in the mouth that I can't polish to a high glaze-like shine (Image 2).


Product: Marcaine®
Category: Local Anesthetic
Source: Cooke-Waite Anesthetics
Rochester, NY
800-933-8031
www.kodakdentalsystems.com

It's about time Marcaine gets a little love! I write a lot about how much I like Septocaine® because I use it in the Rapid Anesthesia Technique, however, that technique is for single mandibular molars or two adjacent mandibular molars. There are many cases, of course, that either still require lower blocks or are in the maxilla. Most of the cases I do are three to five crowns at a time, and the more teeth you prep the better the chance there will be more than one surprise you have to contend with, which always lengthens the treatment time. Marcaine gives you pulpal and soft tissue anesthesia that typically lasts two to three times longer than lidocaine – in many patients lasting up to seven hours. Typically on a larger case the patient will be with us for three to four hours, and I don't want the local anesthetic to wear off on the drive home. We encourage the patient to take 800 mg of ibuprofen before leaving the office so that it kicks in as the Marcaine wears off (Image 3).


Product: LuxaGlaze® Light-Cured Varnish6
Category: Provisional Crown & Bridge Glaze
Source: Zenith/DMG
Englewood, NJ
800-662-6383
www.zenithdental.com

I had an instructor in dental school that told me not to make my temporary crowns look too good or patients will never come back for the permanent crown. Huh? First of all, if you collect all the money at the prep appointment you don't have to worry about the patient not coming back. Does anyone really want to spend $1,000 on a temporary? How many patients really are so in love with the look of their temps that they decide, "Forget that fancy porcelain one, I'm sticking with the superior esthetics of this plastic one!" Needless to say, I strive for gorgeous temps, and LuxaGlaze is a great way to make your temps look like glazed porcelain. Paint a thin layer on, cure for 10 seconds, and admire. If your patient doesn't come back for the permanent crown, it's either because you give lousy injections or your breath stinks. Great looking temporaries keep patients coming back to you for more restorative dentistry (Image 4).

Septocaine is a registered trademark of Septodont.

Published Fall 2008
 
   
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