Letters to the Editor

March 1, 2008

Dear Dr. DiTolla,

Thanks for your article “Clinical Technique: Diagnostic Wax-Ups” in Vol. 2 Issue 2 of Chairside® magazine; it was awesome. I have done a few veneer cases and would like to do more, but I am a little gun shy with the temps. My question for you is this: if you use LuxaGlaze® (Zenith/DMG; Englewood, N.J.) to cure the temps into place, what do you use to cement in your temp veneers? I have had trouble with this stage on a few of my cases. Thanks, and I’m on my way to your website to watch your new “Reverse Preparation Technique” DVD!

– James Hartnett, DDS
Brunswick, GA

Dear James,

My temp technique is a cementless one; the temps are mechanically locked into place. I would prefer to cement them into place, but that is nearly impossible to do. Every time I try to remove the veneer temps to polish and cement them they break. In a case where you are only prepping 7, 8, 9 & 10, you can usually get them off to cement (with TempBond® Clear [Kerr/Sybron; Orange, Calif.]). However, any more units than that and they will typically break. I mechanically lock the veneers into place and keep them on for the shortest time period possible. I find myself prepping into dentin less and less so that I don’t worry about it as much. I consider a minimal-prep veneer to be any veneer that is prepped entirely in enamel, and it has become my goal to use this technique as much as possible. More and more, when the prep ends up in dentin for esthetic reasons, I find myself doing an all-ceramic crown (such as Ivoclar Vivadent’s IPS e.max® CAD) so that I don’t have to worry about exposed dentin and possible post-op sensitivity. I hope this helps!

– Dr. DiTolla

Dear Dr. DiTolla,

Could you please tell me the name of a high-speed handpiece you recommend that is both good and inexpensive? Thanks!

– Name omitted per author’s request

Dear High-Speed Handpiece,

Good and inexpensive? I am not sure if that handpiece exists! I know the CRA has always recommended the Lares® Research high-speed handpiece as a good value, and KaVo handpieces are great if you are willing to spend a little more for durability. My personal favorite is the KaVo ELECTROtorque system. At this point, I won’t use anything but electric handpieces. Electric handpieces allow me to prep crowns better than ever, especially because I can turn down the speed and finish the margins without the water on. Also, I am now able to polish porcelain intraorally with the same ease of polishing outside the mouth, due to the high torque of the electric handpiece. This means any time I need to adjust occlusion after cementation, I know I can get the same smooth polish on the crown as if I had sent it back to the lab! Thanks for the question and I hope that helps.

– Dr. DiTolla

Dear Dr. DiTolla,

Out of the dozens of journals and magazines that clutter my desk each month, there’s just a couple I bother to read — and I have to say I enjoy your Chairside the best. I just completed Vol. 2 Issue 2 from cover to cover this weekend, and was delighted to hear from three icons all in one issue: [Dr. Gordon] Christensen, [Dr. Michael] Miller and [Imtiaz] Manji. Between your technique DVDs and Chairside magazine, you are really doing our profession a great service. I just wanted to thank you and sincerely hope you will continue your dedication and commitment to excellence! Cheers to you!

– Michael Katz, DMD, FAGD
Audubon, NJ