In this final post on anterior tooth preparation parameters, I discuss the significance of creating a precise system for your chosen tools.
by Dr. Lee Ann Brady
Over the course of my blogs on anterior tooth preparation, one important rationale has remained the same: Aim for predictability.
Why do I continue to emphasize this point? Because there is a laundry list of critical elements to remember and keeping track of them all is a difficult task. You need to keep the end goal in mind to achieve the greatest results throughout this complicated process. If your results are predictable, you’ll inspire confidence in yourself and your patient.
Tools and Techniques: Maximize Efficiency With Precise Protocols
You must know your tools to achieve preparation features. Armamentarium is an easily overlooked but highly essential aspect of tooth preparation.
Thoroughness in how you use and maintain tools can have a powerful impact on the quality of the prep. Here are some things to keep in mind for each bur:
- Diameter
- Design of the cutting end
- Coarseness of each bur
Another goal that you can keep in mind throughout the prep is to never put the same bur into a hand piece twice. One way to maximize predictability is to maximize efficiency concurrently.
If you have to keep switching burs and looking for the right one, then you’re wasting time and potentially minimizing the efficacy of your tools.
A Remedy for Inefficiency
The best remedy for inefficiency is to have a consistent system. Procedure kits in particular are useful, specifically if they include the burs your prefer for your individual prep. This should be the foundation of your armamentarium system.
Part of a successful system is following it consistently. So what should go into this system?
- Depth cuts
- Reduction matrices
- Reduction guides
You can use depth cuts to assure the proper reduction can be verified with reduction matrices. You can choose to utilize a variety of materials and styles to fabricate these matrices. It will depend on the type of prep you are working on.
Finally, you should make reduction guides on a duplicate model of the wax-up. That way you are working from final tooth form, position, and size. Ideally, all of these considerations will enable you to verify the amount of incisal reduction in all planes of space on the labial and lingual.
The Value of a Blueprint
It’s a little like building a house. You wouldn’t just jump right in and start hammering away. You would draft a comprehensive blueprint and follow it to the T. Create your prep blueprint and make it precise.
I hope this series has given you a comprehensive understanding of how I approach anterior tooth preparation. I have used these methods successfully in my practice and believe you too can benefit from them. You can read my previous posts in this series on minimal versus aggressive, treatment planning, common restoration alterations, color change, design features, important considerations, and tooth structure.
What system do you use to be precise in your armamentarium? Let us know your thoughts in the comments!