Materials

I don't know if you guys care or not, but the Gators lost in the College World Series last night. I am a bit depressed. Losing in the National Championship game is tough. We are not used to this kind of stuff. I am in a bit of pain.

Today's topic is products I use every day. Just an overview of the stuff I use. Maybe it will spark some discussion.

If you have been a reader for a long time, you know I am a big REALITY guy. REALITY is a company that evaluates all products (well, not all; they only evaluate the products that are given to them to evaluate). They also have a forum that I frequent. This isn't a forum like Dentaltown; you ask a question and a panel of "experts" will all weigh in.

At any rate, the products I use I feel are the best, or at least in the top 3 (it could have been the best at one point and two years later it is in third place, but by this time I have already put it into the rotation and I don't want to change). I am also a big Clinicians Report™ guy.

First, I use Design for Vision 3.5 loupes and I use the Perioptix light that is attached to my belt. I could not go five minutes without either of these. I have a back-up pair of loupes that are brand new that have never been out of the box, but I know I have them.

If the ones I am using break, I would have to shut the place down. What I should have done was have a pair of 4.5 and used them sparingly. And the light. I know if the light goes down, they send you a loaner next day delivery.

I use Septocaine® on all uppers. I use Septocaine locally on all mandibular teeth, premolars forward. If I am working on one tooth I will just use Septocaine locally. If it is a molar and I am doing just one tooth, I will use the Paraject system with Septocaine. If I am doing more than one tooth on the lower, I will give a block and it will be with Lidocaine.

For prepping, I still use a 330 and round burs. I am a big fan of caries detector (the dye that you put on the tooth that stains caries). I use Caries Finder™.
After talking to a biomaterials professor with the 2011 Runners-up Men's baseball team University of Florida, I came up with this way of doing fillings. I etch the enamel and then use SE Bond. I know it sounds crazy, but I love it. I get almost no sensitivity. When someone is sensitive, which is rare, I adjust the occlusion and that takes care of it. I don't use it now, but I am mulling over using Fortify for after my fillings. Dr. Burgess says that using Fortify reduces wear by 15%.

I use Vitrebond on all pulp exposures and all really deep preps. This was kind of a process. I used Dycal in school. Then I used nothing. Then I used Vitrebond. Then I used Durelon. Now I am back to using Vitrebond and am very happy.

For 12 years or so, I was using Flow-It!® flowable resin at the base of my deep preps and class IIs, but I think I am changing to the SureFil SDR® for my flowable. I am not big into changing, but when a guy who does research for a living says that it bonds to tooth 100% of the time, this excites me. On top of my flowable I use 3M's Filtek™ Supreme.

I use a couple of different instruments to carve my anatomy. I don't know the names of them, but I can tell you the one I use the most I think you already have: an explorer. I use the perio probe end to make the pits and the sharp end to start my anatomy from the pits. And let me tell you, they are really looking good.

I finish all my fillings with a small football-shaped, very fine diamond bur with a fine tip on it. And lately I have been using a brownie point too. Then I use the Sof-Lex™ products paper finishing strip for the interproximal.

For class IIs, I use a sectional matrix and a Triodent V3 ring. I use a wooden wedge, a flexi wedge, or the flexible wedges that I have from Triodent. I also have toufflemiers that are curved up and down, side to side, if I need them. I don't have a problem with toufflemiers because of something called the Contact Pro 2, an instrument that can push the contact against the adjacent tooth while you are curing the composite.

As far as placing the material, yes, I incrementally fill. But if you ask 5 different "gurus" how to incrementally fill, you will get 5 different answers. So for now, I am doing it the most convenient way for me. Sometimes I will fill the box first, then the center. Sometimes I will fill parallel with the pulpal floor. Sometimes I will build the walls and move toward the center.

I use a Demi™ light from Kerr. I can't think of anything else that is involved in a filling. Although, that was more than I thought. Let me think of anymore info that I might have left out. I use the same material/resin for everything: anterior, posterior, class Vs and class IVs.

Of all the things that I have told you about today, I think I am the weakest with anterior esthetics. I know there are things out there, nano-hybrids and more esthetic materials, that they claim are more esthetic. But here is my thing: I used to have all that around, but I found they were a real pain in the butt. I would have 40 different shades in body and 40 different shades for incisal edges. I had stuff all over the counter and I would just use two of them. I just didn't do enough anterior composite esthetic cases to have all that around.

That is it for our material lesson for the day. I want to hear about your stuff. Do you use stuff that I left out? Did you find fault in my stuff? We will talk about root canals and crowns on Friday.

Talk to you then.
john