All Ceramic Crown Preparation for Lithium Disilicate #4 KILGORE

[@Dr.Alexandru.Chireu]

Clean and beautiful as always! Btw, thank you so so much from the bottom of my heart for making these videos. They are a great help everyone who is watching them, and they helped me to get into the US 2 years International Dental Program for foreigndentists. I hope I'll have a chance to meet you one day in person! God Bless You!

[@StevensonDentalSolutions]

Thank you for your kind words - hope to meet you too. It's a pleasure helping. RGS

[@Tengrist]

Hello Dr. Stevenson, I'm a denstistry student(2. year of 5) from Turkey, great respect for your clean explanation and your choice of camera angle.

[@StevensonDentalSolutions]

Thank you for watching - best wishes, Dr. Stevenson

[@obo012345]

Keep posting,we’re learning a lot from u. Thank u for the video

[@StevensonDentalSolutions]

Thank you Doc

[@VinayKumar-ch6nb]

Amazing , you work as simple as cutting a cake, and as prescise as cutting a diamond

[@StevensonDentalSolutions]

Very kind of you! Thank you.

[@myrnasharif499]

thanks, Dr. Stevenson, i appreciate very much for your precise and accurate teachings for all your videos. hope some more videos esprcially in preparation of ceramiic, zirconia, pfm. have a good day .!

[@StevensonDentalSolutions]

My sincere pleasure!

[@mohammadkh2620]

Thank you very much from Syria 🇸🇾

[@StevensonDentalSolutions]

My pleasure!

[@tangutooritrinath5291]

Thank u Dr. Stevenson for ur Contribution for the Dentistry..... I am a student from India 🇮🇳..... Learning a lot from ur Videos and guidance........... Plz keep giving ur knowledge, Thank u sir, Regards

[@StevensonDentalSolutions]

Greetings! Thank you.

[@independentthinker1629]

Appears to be a highly skilled workmanship! I wonder how thick the typical enamel structure is that allows so much reduction of the tooth without exposing the dentin structure? Great video!!!

[@StevensonDentalSolutions]

Typical enamel is only 0.3 mm or so thick for the most gingival 1 mm area on anterior teeth and about the same for posterior teeth. It's very hard no to expose dentin for crown preps, even with the new materials. A "Vonlay" (veneer with an onlay) prep will allow for enamel preservation on the facial if it is very minimally reduced.

[@dr.sanket]

just amazing sir, textbook preparation seen like never before

[@StevensonDentalSolutions]

Thank you Doc.

[@drmalek2000]

Thank you Dr Steven , you have a skilled hand

[@StevensonDentalSolutions]

Thank you Doc.

[@dr.yogitaanant4148]

Thank you Dr. Stevenson for such detailed explanation, it’s a phenomenal preparation. Though I am bit late for watching this video.

[@StevensonDentalSolutions]

Thank you Doctor!

[@maamoumaboukhalil9448]

Prof stevenson thank alot lam learing from you different new ways of tooth preparation really dr stevenson the best prof in the world due to learing all , while in the dentistary sociaty no any learn and give advance inforamation like prof stevenson

[@StevensonDentalSolutions]

Thank you doctor

[@hawrazhede]

Welcome back glad to see u again Looking forward for new videos

[@StevensonDentalSolutions]

Great to be back!

[@sungit2g111]

i just watched your video by the end of the month I will open my own clinic

[@StevensonDentalSolutions]

Okay!

[@Dentemnet]

This is great educational video. Can you please enlist all the burs you used?

[@StevensonDentalSolutions]

847KR-016 occlusal clearance KS0 axial reduction 8847KR-016 smoothing occlusal KS0f smoothing axial

[@이명재-y9s]

i envy your golden hand. thx a lot for sharing your technics and tips

[@StevensonDentalSolutions]

Thank you for your support! Dr. S

[@mahdibayati3806]

Thank you dr. stevenson. If possible make a video about custom post made with pinjet and acril

[@StevensonDentalSolutions]

Okay - will do

[@omerrauf331]

Thanks so much for such educational content! Keep up the good work!

[@StevensonDentalSolutions]

I promise I will!

[@sinjo1715]

Tank you so much for the video, very helpfull, keep the good work

[@StevensonDentalSolutions]

Thank you - will do my best

[@layansuleiman8653]

Hello Dr, thank you so much for the amazing videos! Could you please make a video explaining shade selection? Thank you very much !

[@StevensonDentalSolutions]

Great topic! I will in the future. Thank you for watching.

[@hassanouda1953]

These videos are really helpful, thank you so much, Doctor but I still don't know how or when to decide which type of finish line to use !?

[@StevensonDentalSolutions]

I'd use a fillet margin for all ceramics, a shoulder for PFM, and a chamfer for metal margins.

[@muazsalim4431]

thanks for the video,, it really help me with the preparation

[@StevensonDentalSolutions]

Great!

[@rocky-vo9gn]

Tq doctor helped me for my pre clinic work but we can use flat end taper to achieve this outline u have done we usually use flat end taper and anyways tqs doc for the technique u shared

[@StevensonDentalSolutions]

Yes the flat end taper diamonds will accomplish the finish line you are looking for, however, internally they remove more tooth structure. I prefer a modified flat end like a KS 0 or 1.

Finally new video!!!!

[@StevensonDentalSolutions]

Yes, sorry it took so long!

[@KiLLtRoCiTy01]

perfect as always

[@selvarajnatarajan6168]

Excellent doctor

[@StevensonDentalSolutions]

Thank you Doctor.

[@ah-bt7do]

hi Dr. thanx alot plz can I ask you why you dont use tapered bur as usualy text book say instead of straight round end bur and the finish line you did it always above the gingiva why not so close with line of gingiva

[@StevensonDentalSolutions]

Clinically the finish line should be closer to the gingiva or even sub gingival. The tapered but are good but they are wider at the the shank end, making them a bit tougher to use inter proximally. I usually like to create the draw myself rather than the bur but not always...

[@Dr.Youssef_Elatyer]

Good job 👏🏻

[@StevensonDentalSolutions]

Thank you Doc!

[@nausheerpagarkar490]

Great prep sir. Your videos are always so helpful. What do you think about vertiprep ?

[@StevensonDentalSolutions]

Hi - as long as the margin is a fillet and not a knife edge, no problem. The vertical-prep has zero research to support it at this time.

[@HALLELUJAH4EVA]

Hi Dr. On your PFM premolar video, you used a T prep to make an occlusal reduction. In this video, you make depth cuts with a 330 carbide bur. Is one technique more practical than the other? I tried T Prep last week on dentoform & it was frankly a bit challenging. For a second year student, Is it easier/more practical to make depth cuts with carbide or keep practicing and perfect T prep for occlusal reduction?

[@StevensonDentalSolutions]

I hear you! You may with to Tty a combination of the two: use the carbide for the depth cuts, then just reduce one half, so you end up with a wall adjacent to your reduction that allows you to judge reduction.

[@HALLELUJAH4EVA]

now that’s a Stevenson dental SOLUTION! Thank you!! Your work is of great service to students & clinicians alike :)

[@maryamhaqh5482]

Sir if you could let me know..which finish line good supra or subgingival for all ceramic

[@StevensonDentalSolutions]

on the typodont - always supra. On the patient it depends on many factor: esthetic demand, pre-existing wear at the cervical, caries, pre-existing restorations, retention needs, material used, adhesive technique vs cementation...

[@maryamhaqh5482]

@@StevensonDentalSolutions posterior teeth rct treated..all ceramic..rely x used for cementation..no cervical decay..will supragingival finish line be the right choice ..mild gingivitis

[@StevensonDentalSolutions]

@@maryamhaqh5482 yes if esthetics will be preserved.

[@shot336]

happy new year dr all the best

[@StevensonDentalSolutions]

Happy New Year!

[@RADIUMGLASS]

That music was used in NBC's To Catch a Predator.

[@rehamfaisal7761]

Thanks alot dr , can u plz explain vertical prepration ,how to do , which cases and all details

[@StevensonDentalSolutions]

The vertical preparation is one which uses a uniform taper from gingival to occlusal and a knife edge finish line. It is said to conserve more tooth structure at the gingival and leave more enamel intact. The only challenge technicians have with this prep is that Zirconia is very weak and until it is sintered and it is fragile. Also, the final crown can be over contoured at the gingival due to the technician not thinning out the zirconia for fear of chipping. I'm not a fan and will wait for clinical data to support a change like this. Thank you!

[@salihayounis1508]

Thanks can you make acc video on maxillary molars on Colombia and Kilgore and can we use this reduction technique on molars than how we will preserve anatomyn

[@StevensonDentalSolutions]

Yes, will do. You may use the T prep with 2 "T's" - one centered on the MB and one centered on the DB.

[@homejane9719]

The bur you used is radial shoulder for prep ? Round ended tapered bur ?

[@StevensonDentalSolutions]

For an all-ceramic the ideal margin is a fillet, which may be created with a round ended tapered bur or a KS bur. A radial shoulder also works, although ore aggressive - like an 847KR-016.

[@alikhalid3668]

WONDERFUL I am super amazed at your fine work What if we hit the adjacent teeth which can lead to failure at exam Can you make a video how to fix these errors?

[@StevensonDentalSolutions]

Thank you! I usually use a composite disc series and try to maintain contour as I remove the scratches. I would also recommend using an InterGuard (by UltraDent) if allowed, or a FenderWedge to protect the adjacent tooth. Best wishes.

[@alikhalid3668]

@@StevensonDentalSolutions Thanks alot Sir

[@Dr_n27]

Great video, thanks dr Please in next video how to make temporary crown and how to remove it and cementation the final crown

[@StevensonDentalSolutions]

Sounds great - will put this in the queue

[@DoctorAj2023]

Great as always i just have a question can we use KS0 to prepare chamfer margin

[@sheikhnissar6936]

I think , occlusal reduction is 1.6 mm, buccal, lingual , proximal 1mm?

[@StevensonDentalSolutions]

Yes, that will work well.

[@joshalum732]

Hey Doc, you think you will be doing a bridge prep video?

[@StevensonDentalSolutions]

Soon - I've been swamped with patients and courses, but I'm working on it.

[@macrodentistry886]

Can we get 90 degree external line angle with Ks0 bur doc? I am kinda confused when i use ks0 bur bc it lead to sloppy shoulder so i was wondering if it’s acceptable? Much appreciated

[@StevensonDentalSolutions]

When you start out, the shoulder will be smooth and continuous, but not shaped correctly. Near the end of the prep, tip the bur (use the KS0f) so that is is parallel to the root and freehand the refinement of the finish line, to make it 90 degrees externally. This is simple on the facial and lingual and a little more difficult interproximally.

[@macrodentistry886]

@@StevensonDentalSolutions thanks alot doc what i am facing tbh is that when i remove the lipping caused by the same of the bur i end up with slightly obtuse angle as i am using hatchet to remove the lipping…. I will try your recommendations and see the difference thanks alot doc

[@pikaraichu6516]

Your videos are helpfull, thank you

[@StevensonDentalSolutions]

Thank you for watching!

[@kiko5mak]

Can you make class V cavity prep with restoration video please?

[@StevensonDentalSolutions]

I sure will - on a patient I hope.

[@drmarfavs]

Simply amazing. May I ask what camera, lens and lighting system you use for your videos? Thank you in advance.

[@StevensonDentalSolutions]

Canon Vixia GF40 with 2X Macro adapter and two LED lights. Thank you for watching Doc!

[@R900-p6l]

Sir i Really want to know how to have a perfect limit without causing bleading in the gingiva

[@StevensonDentalSolutions]

I like to place a cord first or use Tephlon tale in the sulcus to protect the tissue when I'm not able to place the rubber dam.

[@R900-p6l]

But if i havnt acord. What coule i do

[@StevensonDentalSolutions]

you may try teflon tape or even cotton which is stretched and made into a cord shape.

[@allantheodor6470]

Can I use 847 016 instead of ks0 bur ? My concern is internal line angle which should be rounded so idk if 016 can give that kind of margin

[@StevensonDentalSolutions]

847 will give a shoulder with a fairly small internal radius. I'd prefer the 856-016 for this if the KS is not available.

[@allantheodor6470]

@@StevensonDentalSolutions my board exam provide only 847 and 856 016 and they want shoulder margin so I was think if it’s possible to finish the shoulder with 856 to get rounded internal line angle of the shoulder

[@StevensonDentalSolutions]

@@allantheodor6470 it is - nice

[@charleskocun6754]

What are your thoughts on the Vertiprep? Thank you

[@StevensonDentalSolutions]

To my knowledge there have been less than 5 clinical trials on this design and the conclusions are that it is comparable, yet leaves some patients (up to 25%) with chronic gingival inflammation. Additionally, the time required between prep and delivery isn't going to work well in most US dental practices. My Ph.D. colleagues who look at restoration fractures are not fans of the feather/knife edge finish line associated with this approach. Until more convincing evidence emerges, I woiuld avoid this design and stick with the proven concepts.

[@charleskocun6754]

@@StevensonDentalSolutions thank you for sharing your knowledge! It is truly appreciated. Oddly enough that camp espouses that gingival health is better with a feather edge than any other margin. It’s so hard to know the right choice. However you back your statements up with studies which is very impressive

[@lannyrubin2600]

can you tell me where I can purchase the RGS instruments. I have been practicing for 35 years and never came across these instruments.I believe they will be better than the bite tabs I have been using. Thank you.

[@StevensonDentalSolutions]

Here is the link, Thank you! stevensondentalsolutions.com/product/den-mat-rgs-1-2/

[@lannyrubin2600]

Thanks for the quick response. I just placed the order and can't wait to try these RGS instruments. Needless to say I am enjoying all your videos.

[@om1989gm]

Just another great work.If I may a question Doc how deep would you prefer to go in marginal preparation? subgingival or equalgingival? what would you suggest? thanks for this not only for students video

[@StevensonDentalSolutions]

If esthetics is an issue, I usually go equal gingivally or slightly below (0.5 mm). Otherwise, supra gingival. Thank you Doctor.

[@newworld9338]

Good job

[@potatohead4527]

May i know what is the magnification of your lopes?

[@StevensonDentalSolutions]

6x usually for general dentistry but I also go up to 30x on the microscope for detailed work, endo, microsurgery and implant mechanical rescue procedures, and down to 4.5x for oral exams, and scaling and root planing. I would recommend at least 3.5x prismatic with illumination.

[@potatohead4527]

@@StevensonDentalSolutions thank you doctor

[@Pushyhog]

my dentist growned the shoulder down up in the gum, not visible. implant doc said thats ok. show finished tooth ready for crown and inside of crown fo a great vid. fitting crown to prep. there are million of these same vids weve seen 100 times. show it all in one vid.

[@StevensonDentalSolutions]

Okay

[@haitham172208]

Thank you

[@El_mahdi313]

Hi Dr.stevenson we miss you..

[@StevensonDentalSolutions]

Yes - I'm back finally!

[@hamidazizi6600]

Thank you so much for t he video. We miss you 🌹,,, I thought the finish line should be 1mm, Is there any simple solution to save the neighbored teeth during the prep? The page technique?? I would love to know about fiber post placement and please let me know what kind of material you recommend for crown for the first upper premolar? Thank you 🙏 Hamid

[@StevensonDentalSolutions]

Hi Doctor! Thank you for your comments and questions. The e.max finish line need not be as much as a Zirconia restoration or a PFM. Clinical trials have shown that less reduction is acceptable with lithium disilicate in the axial areas (not the occlusal). To save the adjacent teeth I use small burs and leave a shell which protects the adjacent teeth. For most upper first premolars with no issues with shade and normal function I'd recommend lithium disilicate.

[@hamidazizi6600]

Stevenson Dental Solutions thank you 🙏

[@StevensonDentalSolutions]

@@hamidazizi6600 My pleasure - new videos being edited now!

[@zoldik2107]

Dear dr how much u reduction ( lingual + buccal )

[@StevensonDentalSolutions]

0.6 mm for e.max and 0.8 mm for zirconia is my recommendation.

[@zoldik2107]

@@StevensonDentalSolutions thank you so much dear dr

[@CouplandsSharpener]

Dr Stevenson could you make a video on preparing typodont teeth for a conventional bridge? Thank you

[@StevensonDentalSolutions]

I have one on my website but might do one for KZbin, albeit shorter. Thank you!

[@АнатолицВалерьянович]

What is that? Yep, masterpiece!

[@StevensonDentalSolutions]

Thank you Doctor!

[@ghazalb8966]

Thank you for the video! My question is, is the margin width here for all-ceramics sufficient? I know it should be around 1.2 mm to provide enough space for the ceramic to go on. Please correct me if I’m wrong :)

[@StevensonDentalSolutions]

For PFM you are correct, but not for all-ceramic - this is monolithic lithium disilicate and marginal thickness as little as 0.3 mm are acceptable. We use this for veneers all the time. Thank you for your question.

[@khalidahmed5903]

Great video as always Doc but it took a long time. It would be great if you post 2-3 videos every week if u can. Thnx again Doc we appreciate your hardwork

[@StevensonDentalSolutions]

I'll do my best!

[@m.a.c.4469]

Do you need a fillet with Zirconia Crown?

[@StevensonDentalSolutions]

It would be the strongest, although dentists are experimenting with other designs. So far we have little support for any other design from good research.

[@hadeerahmed1619]

❤️

[@DragoDent]

😍😍😍😍😍😍

[@StevensonDentalSolutions]

Thanks!

[@alitalib4360]

This porcelian or another

[@joshalum732]

Ali Talib Emax is what he said. So Lithium Disilicate. He has videos for porcelain fused to metal (PFM) crowns too. Great content.

[@StevensonDentalSolutions]

Lithium Disilicate (glass-ceramic)

[@Smelly13]

Thumbs and teeth up

[@StevensonDentalSolutions]

Awesome!

[@hadeerahmed1619]

❤️