Bonding Gumline Abfraction - Dental Minute with Steven T. Cutbirth, DDS

[@ojk5556]

i'll be restoring abfraction lesions on a patient for the first time soon. thank you for the detailed tutorial. each step was explained clearly

[@floydjammer6395]

This man has a true love for dentistry. He’s rather refreshing.

[@centerforard]

Thank you. I really do enjoy practicing dentistry.

[@HogrJabar-qz6yb]

The way dr.steven explains anything makes it so easy and approachable and almost tactical 😂 it makes you love dentistry

[@centerforard]

Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@ranjo2860]

Great video, just feel that the TV screen in the background is a little dark and it's making it a little difficult to the whole picture. Great work as always !

[@centerforard]

Thank you. I will pass that comment on to my tehnicians.

[@CnockCnock]

Not much of a commenter but can I congratulate you for condensing a lot of information that is not that readily available into one single video? Well done! As a 26 year old with a lot of abfractions (I wear a nightguard now), I am absolutely panicking of losing my teeth long term. From experience, what would you say the longevity of abfracted tooth are? Greetings from Germany.

[@centerforard]

The longevity of abfracted teeth is excellent so long as you wear a proper nightguard while sleeping and keep your lips together, teeth apart while awake. The only time your teeth should contact is when you swallow, and then only very lightly. Your teeth should not contact when you are eating or certainly not when you are just going through the day.

[@CnockCnock]

Thank you so much for your answer. I do not take this for granted. I have the impression incorrect teeth posture has a lot to do with incorrect tongue posture. Is the correct tongue posture the posture the muscles and tongue assume when you do the "mmmmmmmmmmmmm" exercise?

[@centerforard]

The "mmmmmmmm" sound is primarily for determining correct vertical dimension plus 3mm for freeway space. The "mmmmmmm" sound also places your teeth apart while your lips are together. Tongue position is a whole other discussion, but I do not associate tongue posture with abfraction. Abfraction is from teeth clinching.

[@CnockCnock]

Thank you!

[@evafilija9801]

Great video! Thank you for sharing your outstanding knowledge Dr. Cutbirth!

[@centerforard]

My pleasure! Glad the videos are helpful. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@Jayword]

Malocclusion is also a major cause of abfraction. My patient kept popping off the composite and we fixed his bite with Invisalign. He doesn’t wear a night guard anymore and the pop offs have stopped.

[@centerforard]

I am glad that worked for you. From the studies I have read and my personal experience, my belief is that sleep position has something to do with bruxism and some people just simply grind their teeth while they sleep, even if their occlusion is excellent. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $39.95/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@papito7757]

Great video. I love this channel

[@centerforard]

Thank you! If you like The Dental Minute, you will really like DentistryMasterClasses.com. In Dentistry Master Classes I present complete comprehensive cases that are both simple and most complex. I cover diagnosis and treatment planning and will be including NP interviews, exams and consultations. DMC costs only $15/month (I have made it as inexpensive as possible) and takes you into the catacombs of tier 1, complex aesthetic restorative dentistry. I cover the basic procedures to the most complex, but each case is put together in a comprehensive package. The Dental Minute is simpler procedures, but the procedures are not put together in cases. Try it, I think you will really like it. Then attend the CARD live seminars in Dallas if you are able to do that.

[@eddzallen8317]

hi doctor, amazing video. Ther are products in bonding system where both the primer and primer adhesive are in one bottle. like the two in one generation bonding system. Is it better if the primer is separate from the primer adhesive?

[@centerforard]

No, I like to etch separately, then use primer/adhesive in the same bottle. We had a seminar at my teaching center in Dallas (The Center for Aesthetic Restorative Dentistry, CARD) this weekend and invited the main materials and research expert from 3M to present Saturday afternoon on composites and cements. Very interesting.

[@MrBaladaum]

Hey doc Steve do you use rubber dam for extractions really?

[@centerforard]

Yes, if there is a tooth on both sides of the tooth to be extracted allowing a rubber dam clamp to be placed, I often use a rubber dam to keep the water and bits of debris out of the patient's mouth and to keep the tongue and cheeks away from the surgical site. Also, I find it relaxes the patient because they are not worried about things in their mouth.

[@Dunkeeez]

Hello MR.Cutbirth! Thank you for the lesson! It helps a lot :) What you think about not using a rubber dam in this particular case. For quite a while rubber dam usage has become a new standard in restorative dentistry. Don't you think that oral fluid effects the adhesion? Thank you so much!

[@centerforard]

The key is to isolate the teeth, either with RD or 2x2 cotton squares. I use a RD with the method I am teaching for almost all procedures. I felt 2x2 cotton squares for isolation was satisfactory in this situation. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.

[@rheakittenss]

Hello Doctor Cutbirth ,such great videos ,so much to learn,thanks for sharing the knowledge .and you are a great SPEAKER.Thanks Dr Kaur Virginia

[@centerforard]

Thank you. In what country do you reside and practice?

[@rheakittenss]

I practice in Manassas,Virginia .USA an hour or so from Washington DC

[@snehagthomas6219]

Hello doctor... Why don't we use gingival retraction in this case?..

[@centerforard]

I do not need the retraction cord to place the resin restoration and I do not want any gingival bleeding. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@nadinemichael1540]

Is it necessary to fill abfractions if it’s not bothering me? Sometimes I feel sensitivity but it’s not terrible.What happens if we leave the abfractions without filling. Mine are not too deep, they barely ever show but my dentist insists I get it done.I have a night guard so hopefully it doesn’t get worse. Also what do you think about Botox injections into the Masseter muscles for teeth clenching? Do you recommend?

[@centerforard]

Sounds like you are getting good information from your dentist. I do not use Botox for myofacial pain. I prefer to treat the cause of the myofacial or TMJ pain/dysfunction.

[@pathfidelino5424]

i have that kind of tooth repair, but after the repair its more become sensetive to cold water and when biting hard like nuts. before the repair its okay, no problem. and also when im exhaling to that part my teeth is more sensitive. almost 3 weeks now after repair and still there. is my dentist fail to repair my teeth or its normal?

[@centerforard]

Most dental procedures are very technique sensitive, meaning the small parts of the procedure are important to achieve a good result. Several important parts go into achieving an excellent result.

[@lizcoffey5538]

I got Invisalign in March and now it's May and I noticed my two bottom back molars on either side look like they have a cavity at the gum line. This really freaked me out and I have a dentist appointment in a few weeks. I was surprised because I literally just had a cleaning and a filling on a couple molars on top of the tooth in December. So to see what I think are cavities on both of my molars is shocking. Thank God I found this video because I think that it's from clenching my teeth. My dentist should definitely be able to tell the difference between a gum line cavity and abfraction. My question is because I have to wear my Invisalign for 22 hours of the day how am I supposed to keep from clenching at night when I have to have my trays in? I definitely am a clencher and I used to have a night guard before Invisalign many years before that I stopped wearing. I'm a chronic worrier and so I just clench my teeth all the time throughout the day. I like the tip you gave about going mmmmm because I had no idea that my teeth were not supposed to touch. I'm really worried because I'm spending thousands of dollars on Invisalign to have these teeth issues I don't know how to stop clenching. And I don't know what I can do.. any advice?

[@centerforard]

Before or following the Invisalign, have any teeth issues restored, then have a nightguard fabricated.

[@tij7145]

Great video! What do you think about optibond xtr system? Prime and bond prior to composite placement instead of etching?

[@DragonBreathJeff]

Tiffany Jacob , the optibond xtr system has the etchant combined with the primer.

[@centerforard]

Etchant is in the primer/adhesive. I don't use it, but do not know that much about it. This method has worked beautifully for me for many years, so I am not looking for another system.

[@SK-bi8uq]

Hello Dr! Thank you for a very informative video. In our school we learned we should use a 1/4 bur and place a 1mm groove on the gingival margin for added retention and bevel the occlusal margin before adding composite. Does this depend on a case by case basis?

[@centerforard]

Remember, with composite the retention comes from bond strength to the enamel and dentin, not mechanical retention. With cervical composites, I want to be sure the prep is into fresh dentin or enamel. Be sure to remove all the "soft" dentin. I am not familiar with the 1mm groove. Beveling the margin a bit will help make the margin "invisible," blending the composite with the enamel of the tooth. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@julieo3860]

Thank you so much. Excellent teaching.

[@centerforard]

Thanks. Glad you like the videos.

[@mathewvanostin7118]

Sir, i have a question, is white resin composite to cover a exposed root tooth necessary if all mouth healthy? My teeth are good. But i have gum recession on a specific area. And a small section of my tooth root do show up So i would like to know can i simply apply good dental hygien and not go forward with this operation? If a tooth root is cleaned with good dental care. It would protect it right?

[@centerforard]

Composite bonding is not needed if there is only recession and no abfraction.

[@likaalatif6968]

Thank you it’s very helpful thanks thanks thanks

[@centerforard]

You are welcome! These procedures work and have worked for many, many years. My objective is to teach you these procedures systematically so you do not have to figure them out by trial and error and have to deal with failures. Be sure to follow every step exactly. Do not vary or leave out any of the steps.

[@amnafarhat688]

Amazing! !

[@centerforard]

Thank you.

[@ceciliahazard8459]

In this video, it looks like you are using a primer + adhesive (2 in one system). At my school. We have to use scotchbond multipurpose, where primer and adhesive are applied separately. Could I still use your technique of keeping the tooth wet after rinsing off the etch? While using the 2 part system.

[@centerforard]

The dampness is for the primer. Why not use 2 in 1 and save a step?

[@ceciliahazard8459]

Our clinic only offers the 2 part system for students. We’d have to purchase materials on our own and have them approved for use in the clinic

[@centerforard]

The 2 part system works fine.

[@douglasachaiba7885]

Good day. When etching enamel only, do you treat it as the dentine? As in leaving the moisture on the tooth after 45 secs etch and applying the bond. Thanks.

[@centerforard]

Yes.

[@douglasachaiba7885]

Dental Minute with Steven T. Cutbirth, DDS thank you Doc. I have been using all your dental tips and tricks and my dentistry has improved and I feel so much more confident. Thank you for these videos. God bless Sir.

[@centerforard]

Subscribe to DentistryMasterClasses.com if you want the best cases, information. There is a library of all the videos and PowerPoint cases and lectures plus many complete, comprehensive cases. $15/month! Don't think about it, do it! That's where the real learning is!

[@TheKitchus]

Awsome video love from India ⚘

[@centerforard]

Thank you.

[@flee78]

You're #1

[@centerforard]

Thank you. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@masoud_s5430]

Tanks dok

[@centerforard]

You are welcome!

[@GretzkySanders]

Another Great Video Doc, i am sorry but i do have to ask...is that beautiful young lady at the end of the video your wife. If so you went into extra hero status...keep up the great work!

[@centerforard]

Ha, ha. No, that is my youngest daughter. My wife and older daughter are also drop dead beautiful and all of them are brilliant. Thanks for the complement.

[@tayloranderson456]

Looks nice but that still doesn't help with the gum recession, wouldn't it be better to get gum surgery?

[@centerforard]

Gingival grafting is always an option. But the level of gum elevation is dependent on the height of the bone surrounding the tooth/teeth being grafted.

[@dr.Mo_Awahed]

DR Steven what is the type of alcohol do you use on the isolating cotton and dose it save for oral tissues

[@centerforard]

Isopropyl.

[@shankhaghosh2628]

Sir wil the gum grow back over the filling.

[@centerforard]

Normally not. Gingiva does not normally grow back over fillings. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month. Click here to subscribe: membership.dentistrymasterclasses.com/purchase/?plan=513

[@shankhaghosh2628]

@@centerforard Sir my low front incisor teeth are in the same condition as the incisor teeth shown in this video. So will my gums grow back as I am a teenager or I should consult to the dentist. And is there any risk.

[@centerforard]

Speak with your dentist.

[@shankhaghosh2628]

@@centerforard Ok sir

[@shankhaghosh2628]

Will the gums grow back ? Plz tell sir.

[@puttaanjaneyulu3735]

Bur will runover into the soft tissue ...if u don't know the movement and direction!...and that definitely suks

[@centerforard]

I have no idea what you are referring to.

[@whatisit1746]

I think it is from clenching at night, while sleeping.

[@centerforard]

Correct. Wear a nightguard.

[@starr38127]

I wish I could repair them naturally. I'm sure this is expensive

[@centerforard]

There are many things in life I wish were magically fixed.

[@starr38127]

I actually did get a good fix..... Teeth are better gums feels a hell of a lot better. I guess I did find some magic.

[@moneyjoyk]

I would send you my school fees..I learnt more from you

[@centerforard]

Subscribe to DentistryMasterClasses.com. All videos plus comprehensive cases, an organized library of all the videos plus important articles.

[@FL-gg4dq]

Your wife is gorgeous

[@centerforard]

I agree, and brilliant and she has a fabulous personality and is lots of fun! We have been married 43 years.