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Chairside Magazine – Photo Essay: Ensuring Adequate Reduction with the Reverse Preparation Technique

Launch Course

Course Objectives (1 CE Credit)

Michael C. DiTolla, DDS, FAGD

Across the United States, one of the problems that can hamper the quality of a dental laboratory’s output is that of inadequate reduction on crown and bridge preparations performed by dentists. While modern monolithic materials have significantly relaxed the reduction requirements across all indications, the issue continues to persist. In this presentation, Dr. Michael DiTolla utilizes the Reverse Preparation Technique to precisely control the amount of reduction while replacing existing crowns and restoring compromised natural dentition in the anterior with monolithic zirconia restorations. Participants who view this presentation will gain valuable insight into predictable restorative techniques, including:

  • Accurate shade-taking
  • Matching anterior restorations to adjacent dentition
  • Bur types and functions
  • The Reverse Preparation Technique
  • Cord-packing to increase impression quality
  • Locating carious lesions
  • Light-curing composite buildups
  • Techniques for reducing voids and pulls in conventional impressions
  • Removing salivary contaminants in zirconia restorations
  • Replacing unesthetic restorations in the anterior

Summary

Clinicians who adopt preparation methods that ensure their reduction amounts meet the requested material’s requirements will be rewarded with results that seat, function and look better than the restorations of those who elect to not measure. In this presentation, Dr. DiTolla demonstrates how adding a simple, step-by-step reduction methodology, such as the Reverse Preparation Technique, enables clinicians to know their preparation is ideally suited for a specific material, reducing the chances that a case must be returned to the lab at the final delivery date.

CAUTION: When viewing the techniques, procedures, theories and materials that are presented, you must make your own decisions about specific treatment for patients and exercise personal professional judgment regarding the need for further clinical testing or education and your own clinical expertise before trying to implement new procedures.


References

  1. Kois JC. New paradigms for anterior tooth preparation. Rationale and technique. Oral Health. 1998 Apr;88(4):19-22, 25-7, 29-30.
  2. Schmitt J, Wichmann M, Holst S, Reich S. Restoring severely compromised anterior teeth with zirconia crowns and feather-edge margin preparations: a 3-year follow-up of a prospective clinical trial. Int J Prosthodont. 2010 Mar-Apr;23(2):107-9.
  3. Yoshida A, Miller L, Da Silva JD, Ishikawa-Nagai S. Spectrophotometric analysis of tooth color reproduction on anterior all-ceramic crowns: Part 2: color reproduction and its transfer from in vitro to in vivo. J Esthet Restor Dent. 2010 Feb 22(1):53-63.
  4. Lokhande NA, Padmai AS, Rathore VP, Shingane S, Jayashankar DN, Sharma U. Effectiveness of flowable resin composite in reducing microleakage – an in vitro study. J Int Oral Health. 2014 Jun;6(3):111-4.
  5. Wöstmann B, Rehmann P, Trost D, Balkenhol M. Effect of different retraction and impression techniques on the marginal fit of crowns. J Dent. 2008 Jul;36(7):508-12.
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