Microdental prep

[Glenn van As]

Here is another case where the distal pit was in the 20s with the diagnodent and so I removed the mesial pit FS not knowing if there would be anything under it and in this case there wasnt but in many cases there is.

Other cases similar to this can be found at the following links……..

http://www.rwebstudio.com/cgi-bin/ikonboard/topic.cgi?forum=25&topic=27

http://www.rwebstudio.com/cgi-bin/ikonboard/topic.cgi?forum=25&topic=31<img src="https://www.laserdentistryforum.com/attachments/upload/Resize of Class one microdental prep case 2.jpg

” border=”0″>

[Glenn van As]

Here are the pics from the other case I wanted to show.

Glenn

[Glenn van As]

Here is a tooth that I am going to prepare soon , which shows the same tooth at the 6 steps of magnification under the scope and how the decay becomes more noticeable with high mag.

The patient has decay on the lingual grooves (both of them) and in addition on the diagnodent it was 27 . THe magnification helps me find the spots and then the diagnodent confirms what visually I notice.

(trying to build my case here!!)

Glenn

[Glenn van As]

Am I making anyone else uneasy besides myself from all those darn fissure sealants they told me in dental school to plug in if there was stain and no cavitation?

Another one for the books.

Glenn

[Glenn van As]

Just to show you that I dont do them all with my laser.

Here is a fissureotomy bur which opened up a non cavitated but visibly discolored lesion which was large (forget the number) on the diagnodent.

Glenn

[Glenn van As]

Ok ok I have made a point…….one last one .

Glenn

[Patricio]

Glenn,

Two comments.  I was trying yesterday to decide what curing light to take with me to Bolivia next week and realized that we rarely use the lights in hygiene  except for spot bleaching.  We simply are not doing sealants anymore.

Yesterday I also had a moment when I realized how much more beautiful the tooth was under high magnification.  Must be like seeing the moon at 16x!

I also opened an occlusal as you are showing only to find the deepest decay was not where the DD had indicated.  Maybe 16X would have noted this area better.
Thanks,
Pat

[Anonymous]

QUOTE

Quote: from Glenn van As on 2:53 am on Mar. 1, 2003

How are you handling the following:

1. Fissure sealants
2. Preventative Resin restorations where there is a little bit of decay in one pit.
3. Decay around Fissure sealants

Glenn

Glenn,

I haven’t placed conventional sealants in the last 2-3 years.

When I’m restoring  part of a tooth I have been using flowable in the deep grooves on the remainder of the tooth if there is no discoloration and very low Diagnodent numbers(after laser etch or air abrasion).

In the last couple months, if there is no restorative planned for the tooth but I still feel a sealant is warranted, I place Fuji Triage.

If there is decay around a sealant ,I remove the sealant when treating the decay and do one of the above along with the restoration.

Its sometimes difficult to tell around old sealants if the sealant is just stained or there is decay starting. This is another place the higher power loupes seem to help.

[Swpmn]

I totally agree with you Glenn and Ron. We place very few fissure “sealants” these days. The fact is conventional “sealants” were probably only good for fissure anatomy that wouldn’t get caries in the first place!!!!

Al

[Benchwmer]

Since I started using Air Abrasion about 9 years ago all my sealants are prepared w/ microabrasion, bonded w/ DBAs, then restored w/ flowable composite,
If any stain or caries present I remove all resin w/ AA. Need magnification.

[img]https://www.laserdentistryforum.com/attachments/upload/Before.JPG[/img]

See case:

[img]https://www.laserdentistryforum.com/attachments/upload/Before.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/After AA.JPG[/img]

Note more caries present under intact sealant that unsealed grooves or failinf sealant
[img]https://www.laserdentistryforum.com/attachments/upload/Restored.JPG[/img]
Note dentin caries after AA. This is what I got Erb:YAG for for caries removal and disinfection.
I use a 7th generation DBA, I-Bond for 30 seconds, thin w/ air, No light cure yet.
Restore w/ flowable composite, vibrate out any bubbles, light cure.
Adjust bite, polish.
If after AA if not into dentin, charge out as sealant. If into dentin, charge out as a one surface restoration.
The bonding agents have changed over the years, but predictable, conservative, microdentistry.

[Author]

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