Class II Amalgam Preparation #14 MOD | Amalgam Preparation Technique

[@ExodusLoui]

Brilliant video once again. I'm a dental student and I find these videos better than the content from my faculty. Would like to see more regular content (:

[@StevensonDentalSolutions]

I was a professor at UCLA for 26 years and Chair of Restorative for 17 years, so I have first hand experience what is lacking in education! Will continue to help!

[@shyhememcelroy2047]

Stevenson Dental Solutions that’s awesome!!! You are an amazing teacher!

[@StevensonDentalSolutions]

You are very kind!

[@frontdesk7212]

@@StevensonDentalSolutions I am a foreign dentist and I haven't practiced in 4 years. I finally got a few calls for interviews and will have my first bench test this upcoming month. You have no idea how much your videos have helped me in preparing for my test. I just want to thank you for the amazing work and for spreading your knowledge worldwide.

[@Nami-wf3hq]

I am a student of INC Dental Specialties Institute and I am going to obtain my license to Register Dental Assistant in Extended Function, I tell you that your videos are seen in class and they are helping us a lot in the formation of our career, thank you so much for your videos.

[@Rivu0904]

Sir, doc, you are the new sunshine in restorative dentistry. Keep up the good work. Already an admirer of you.

[@shamimriahi9895]

Doctor, i thought it would be intresting to know some dental students from Iran are finding you videos way more useful than 6 years of dental school, Thank you❤

[@stevenlopez1717]

Excellent video Dr. Stevenson, as a D1 myself, your channel as a whole is a resource I truly value

[@StevensonDentalSolutions]

Great - thank you for watching and best wishes to you! Dr. S

[@SudarshanTonk]

Thanks Dr Stevenson for being generous to give us information to better ourselves in our clinical work. You are always so humble ,for me your preps are like perfect only. The quotes you give during demos are like icing on the cake and I write them down to follow them.

[@StevensonDentalSolutions]

Great, and thank you, Dr. S

[@tithidakhave4341]

I am a dental student from India and my friend and I came across your videos today they r mind blowing and amazingly helpful!!!

[@StevensonDentalSolutions]

Great! It is a true pleasure to share them. Dr. S

[@tithidakhave4341]

Are there any written notes available that you have published on amalgam cavities??

[@oliviatrombley452]

Thank you for all of the effort that you put into creating this content Dr. Stevenson. I'm a first year student at UNC and you are big reason why I am thriving in COD!

[@StevensonDentalSolutions]

WOOHOO! You made my day.

[@joshalum732]

Amazing videos. Learning a lot and also very satisfying to watch you do these perfect preps!

[@zondafive2062]

I saw some of your videos, you have hand skills like text books. Only one out of few hundred dental students have that kind of hands.

[@StevensonDentalSolutions]

Thank you!

[@dounya3431]

Thank you so much doctor, your videos were really useful, and you mentioned a lot of important information 🙏🙏 much appreciation

[@StevensonDentalSolutions]

My pleasure Doctor!

[@abdualatr6844]

Nice prep Steve. I am a Dentist since 1993, I learned much from your video Thanks

[@StevensonDentalSolutions]

Thank you Doctor!

[@marcelchrobot8317]

really helpful video, thank you so much, hope there will be much more content for dental students

[@StevensonDentalSolutions]

Thank you!

[@Alpha-cd7pw]

very clear illustration , nice & easy steps to follow and of course great results. Thanks Doc these videos helped me way more then the content from my prof. Thanks a lot

[@StevensonDentalSolutions]

Great! Thanks.

[@burbz1000]

Awesome! It would be more awesome if you also take a shot of your seating position during every step (or at least when it changes)

[@StevensonDentalSolutions]

Yeh, good idea. We plan to make some chair position videos in the future. Thank you!

[@bilaljaved8792]

amazing and unbelievable preperation

[@ammusjohny5220]

Good video doctor.. its really helpful in understanding preclinical conservative dentistry..

[@StevensonDentalSolutions]

Thank you.

[@Nour_nl8mh]

Not PERFECT! GOD It's AMAZING !!!

[@StevensonDentalSolutions]

☺

[@justsayin5110]

I’m glad that I knew this channel. Subscribed with excitement!

[@StevensonDentalSolutions]

Awesome!

[@fatimaarsalan3202]

Thanks a lot Dr! Beautiful work. Really helpful for people who are appearing in exams. Could you please make a video on MoDB amalgam filling as well?

[@StevensonDentalSolutions]

For sure! Stay tuned and thank you for watching.

[@khalidmahmood8589]

Thank you so much for excellant video once again

[@StevensonDentalSolutions]

Always a pleasure!

[@zahrazubair3888]

Thankyou sir. Your videos are very helpful

[@StevensonDentalSolutions]

My pleasure!

[@umairlakhani7166]

Great video Dr. S. A lot of us are working at offices that are heavily CAD/CAM oriented. Would love a video where you speak about preparation principles, tips and tricks and more info that you'd deem useful. Thank you for your videos, they're informative and fun to watch #gobruins

[@StevensonDentalSolutions]

Will do!

[@umanas8870]

Great doctor, I like your use of hand instruments instead of rotary instruments when It is possible

[@StevensonDentalSolutions]

Great - they are indispensable!

[@fullmalakizamaseels]

Thank you sir from Pakistan 🇵🇰 ❤

[@StevensonDentalSolutions]

My pleasure!

[@mohamedserag216]

That was very helpful..thank you so much Doctor

[@StevensonDentalSolutions]

My pleasure!

[@lifeisendo]

Dr Stevenson we all have benefited from your meticulous hard work and efforts in our journey towards excellence. Please can you make a MOD on 36,46 on the Kilgore multilayer A27 carious tooth one side proximal with and one side without hand instruments. I am preparing for the practical exam in Canada . Thanks so much Regards

[@StevensonDentalSolutions]

Thank you, okay tooth #19 MOD and #30 MOD on the Kilgore - will do!

[@shirindokhtraad]

Fabulous

[@sakureema9899]

please dr, make another video for mandibular first molar MOD. Thank you very much

[@StevensonDentalSolutions]

Will try!

[@alokpol3312]

Dear Dr. Excellent content as alaways. Please can you cover preparations and exercises from Assessment of clinical skills exam of canada?

[@bilgenur2539]

It is really perfect 👏👏👏

[@StevensonDentalSolutions]

Oh, you are very kind, but I see flaws...

[@ndpitch]

Do you find that hand instruments can be used clinically in the way they’re used on the typodont teeth? Maybe our hand instruments in dental school weren’t properly sharpened, but I don’t remember being able to undermine and create a bird beak, and shave it off so cleanly with the hatchet, like you do on the typodont teeth. I currently don’t have hand instruments in my operative cassette but these videos are making me want them back again!

[@StevensonDentalSolutions]

Yes, absolutely - I use them all the time clinically. Yes, they must be of high quality and sharp. Most dental school instruments are neither! I use them for composites, inlays, inlays, and even crown preps. I will make a video soon of clinical procedures - like an inlay or composite prep. They actually work better on enamel than plastic. Rich

[@ndpitch]

Clinical videos would be awesome!! Thanks a bunch!

[@consuelovillanueva9251]

There is any video showing resin preparation ? Could you tell me the main difference from the amalgam ? Thanks Dr.

[@StevensonDentalSolutions]

Try this kzbin.info/www/bejne/o3SkZYWCa7KGmck - we have a really good webinar on our site too ; stevensondentalsolutions.com

[@yassermhammad5377]

Nice work ceep going 🌹

[@StevensonDentalSolutions]

Will do - thank you!

[@gian-marcodandrea116]

Hi there Dr. Stevenson. I just wanted to say I've pretty much watch all your KZbin videos and found each one to be incredibly informative a well as inspiring. I hope one day to be able to match the precision of your preps. I was just wondering if there was a text book you might recommend describing the dimensions and outline form of common cavity and preparations along with the rational for such features. I studied at Kings college London, England and was never taught this level of detail when planning our cavity preparations. Please keep up the great work!

[@StevensonDentalSolutions]

Not to my knowledge. I do have a plan to publish a text which would be an atlas of ideal preps someday. I think this would be very useful. Until then, I'll keep at it! Thank you for your support and comments. Dr. S

[@MubiruWilson-dental]

Thanks

[@StevensonDentalSolutions]

A pleasure!

[@naderesi]

Thank you doctor, i have got a question, should we remove oblique ridge in pre clinic ?

[@StevensonDentalSolutions]

Not unless the groove is carious. Usually leaving the Oblique Ridge is best.

[@jancymathew256]

Excellent

[@dentistdentist7627]

Thanks for your helpful video Could u plz do provisional crown demo

[@StevensonDentalSolutions]

I will! Good topic - stay tuned!

[@mustakeempatel3502]

Can u show this on kilgore plastic pls...or do u have the video

[@StevensonDentalSolutions]

I will put this in the Queue

[@dentistdentist7627]

Could you please do this prep on caries teeth and how to remover unsupported enamel!!!

[@StevensonDentalSolutions]

Yes - also, take a look at the large amalgam video and also the videos on the direct composite onlay - lots of this is covered. Thank you!

[@davidpourmohammadi9754]

great video

[@niharshah8325]

is it necessary to extend into buccal and lingual grooves in class 2 prep ?

[@StevensonDentalSolutions]

They are primary grooves, so it's good to do this to demonstrate your awareness of the typical caries pattern.

[@hennyle95]

If you realize you lack enough gingival clearance when you chip away the proximal box enamel shells, what would you do in that case to minimize iatrogenic damage but lower the gingival floor?

[@StevensonDentalSolutions]

Hi Ryan, in this case, I use the “Sturdevant Chip” technique. Use a 245 and position the bur against the axial wall. Drop the bur ginigivally about 0.3-0.5 mm (takes some practice bur it’s very repeatable), while just skimming the axial wall as you move the bur buccolingually. You will have created a ditch in the gingival which leaves a small wall (a lip) adjacent to the proximal tooth. Now use either an enamel hatchet or bin-angle chisel in the ditch and rotate the instrument with the cutting edge swinging towards the adjacent tooth. The little wall will easily chip off, thereby gaining more clearance. Smooth the margin as you always would with burs and the hatchet or ginigival margin trimmer and you should have an iron clad predictable method for this requirement of class II preparations. Note: Sturdevant, - I knew him personally - was a humble gentleman and would never have named this after himself. Thank you - I hope this helps. I plan to demo this in an upcoming vid!

[@alikhalid3668]

Hello Dr. What should be the maximum width of the cavity. It gets wider, especially in the isthmus area. Our exam recommends by saying the smallest Condensor provided should pass easily( which measures 1.5mm ).

[@StevensonDentalSolutions]

I usually try to keep it about 1.0 mm - we use small condensers/

[@alikhalid3668]

@@StevensonDentalSolutions Thank you Sir

[@juilishivde6577]

can you please make a video on MOD premolar?

[@StevensonDentalSolutions]

Yes - will do!

[@zhiwaskalimba4096]

Perfect video .. but i just wish your videos were alittle shorter .. otherwise its all great thank u so much 💜

[@StevensonDentalSolutions]

Oh - straight to the point with little lecturing - got it.

[@melissaromain3279]

Can someone go over the line angles and point angles for this prep?

[@StevensonDentalSolutions]

LINE ANGLES: Buccopulpal, Linguopulpal, Axiopulpal, Axiogingival, buccogingival, linguogingival, axiobuccal, axiolingual. POINT ANGLES: axiobuccopulpal, axiolinguopulpal, axiobuccogingival, axiolinguogingival. You may add "in the mesial box..." or in the distal box..." for a more specific description.

[@fuadramadani3593]

do you have a Composite preparation for the same tooth ?

[@StevensonDentalSolutions]

Not yet but I have placed this in the queue. Thank you.

[@paulchahal7545]

How much should be the isthmus width? 1.2mm? Which instrument can I use to measure the width?

[@StevensonDentalSolutions]

I try to keep the isthmus between 1-1-5 mm - the RGS 3 is 1.0 mm.

[@user-nx8fn7jg1r]

How do you get the matrix adapted to the gingival seat when the adjacent tooth is missing?

[@StevensonDentalSolutions]

GREAT QUESTION! You don't usually, however, no worries, it is totally accessible and easily corrected with an IPC or Hollenback after removing the band - with amalgam. With composite, I'd use a #12 blade or composite knife followed by thin composite finishing discs.

[@user-nx8fn7jg1r]

@@StevensonDentalSolutions Thank you. The thing is that I find the amalgam keeps leaking on condensation from this opening between the band and tooth margin at the gingival seat and fill the gingival sulcus before the cavity.

[@StevensonDentalSolutions]

@@user-nx8fn7jg1r Okay - here is a more advanced technique. Place the band as usual, then cut a small piece of the matrix material (a shim), about 10 mm in length, and insert it in the area where you have no adjacent tooth, extending beyond the buccal and lingual proximal walls, then insert a wedge vertically between the shim and the band and secure with composite or compound. this will seal the gingival area beautifully.

[@user-nx8fn7jg1r]

@@StevensonDentalSolutions Thank you for this invaluable information. I would appreciate it, however, if you could do a video demonstration of this technique. Thank you again.

[@StevensonDentalSolutions]

@@user-nx8fn7jg1r Okay - I'll try!

[@jancymathew256]

I watched many times n it is extremely helpful . Just a doubt . He buccal wall of distal box looks flared a littl to me . Pl do correct me if I am wrong . Thanks again

[@StevensonDentalSolutions]

Hi, it might be by 1 degree but it’s very close. It’s always better to be flared up to 5 degrees vs. being potentially undermined. Imagine a matrix band around the tooth and visualize the angle which the amalgam will make at the cavosurface. I think that you’d agree that in this prep we’ve satisfied the criteria. Best, Dr. S

[@jancymathew256]

Stevenson Dental Solutions thanks very much for the quick response. Perfect

[@smithasmith8508]

Hi,I would like to know if it’s just a DO where do we start the outline of the preparation...

[@StevensonDentalSolutions]

Hi Doc - two choices: either extend all the way to the mesial pit and cross the oblique ridge, or perform a DO which is entirely restricted to the area distal to the oblique ridge. With the first option, it's more aggressive, however, it is very retentive and relatively easy to perform. With the second option, the difficulty lies in obtaining enough retention without damaging the DF cusp with a dovetail. For the distal only prep, start with the BOX and complete it, THEN add enough retention with the occlusal form. This technique works well with small DO and MO preps on lower first premolars as well. I'll demo this video soon! Thank you for the excellent question. If you email me, I will send you a photo: [e-mail]

[@smithasmith8508]

Thanx a lot doctor..will look forward for the video..

[@sanhitachatterjee]

Hi we don’t get enamel hatchet for our exam. Is there any other instrument or ways that can be used for the proximal boxes? Thanks

[@StevensonDentalSolutions]

Oh that is just mean! Any chisels at all? Hoe? Off-angle? Bin-angle? Hopefully you may use some instrument - if not, you'll never be able to create defined axioproximal line angles. Very strange for a school to subject one to this. Anyway, do the best you can with the tip of the bur to obtain the proper extensions on the buccal and lingual of the box. It can be don, but it's like asking an F1 driver to take one of the wheels off the car and win a race. BOO!

[@Sfaradjew]

Use a marginal trimmer!

[@aisyas4639]

Gingiva marginal trimmer

[@assaultytheshooter9929]

hi I would like to ask is this the preparation for all levels of decay if so if a tooth doesn't have a large amount of decay spreading to the outer case at both sides of the tooth then why are the walls of the tooth breached on both sides surely it would make sense to keep the shell of the tooth intact as to make a shell for the filling to sit and mould with giving the tooth more integrity in some videos they even go as far as making a complete + shape breaking the integrity of the tooth both sides

[@StevensonDentalSolutions]

For amalgam: There are at least the following 20 designs available to treat class I /II caries, depending on the clinical situation: M (Box only) MO (leave the oblique ridge), D (Box only) DO (leave the oblique ridge), MOD, MODL, MOL, DOL (leave the oblique ridge), DOL cross the obliques ridge, MOB (leave oblique ride) MOBL, DOBL, MODBL, O+O+O, O+O, OL , OL (leave the oblique ride) OB, L pit, B pit in combination with most of the above. For Composite: Same as above with more conservative extensions. Thank you for the question!

[@assaultytheshooter9929]

+Stevenson Dental Solutions thank you for answering it looks quite similar to learning to play guitar but I understand that their is different options depending on the situation thank you

[@Shadeakald]

Great, Kann du write me the name of this Hand Instrument ? I watch from Germany und didn’t get every thing 😥

[@StevensonDentalSolutions]

10-6-14 enamel hatchet for the boxes, RGS1-2 and 3-4 for measuring. Both available from stevensondentalsolutions.com

[@mohamedshendy9324]

the design of class 2 for amalgam is the same design of the class 2 for composite?

[@StevensonDentalSolutions]

No. The class II composite has rounded internal line angles, and may have slightly more flared proximal walls. It may be slightly less deep pulpally and slightly less extended interproximally.

[@mohamedshendy9324]

thanks for answer... plz can you make vedio about the class 2 cavity prepation for composite to learn make class 2cavity preparation because i dont know the shape the box of the interproximal of mesial or distal the problem is the the shape of the box plz the doctor... this will make me happy because i can not sleep.. i can not make the box of the class 2 mesial or distal and this make me abad dentist

[@StevensonDentalSolutions]

@@mohamedshendy9324 I have a few other videos on class II in the Class II Composite Play List on the content page of the channel. Wishing you the best. Dr. Stevenson

[@mohamedshendy9324]

thanks for your the reply. you are respected man and the best dentist in the world

[@StevensonDentalSolutions]

@@mohamedshendy9324 You are too kind. Best wishes, Dr. Stevenson

[@ioanamiruna1991]

What can I use instead of 330 RGS bur?

[@StevensonDentalSolutions]

245 - longer (3 mm vs 1.5 mm) and great for cutting on it's end.

[@hetpatel6341]

Bro natural enamel.does not chip off so easily with hatchet

[@StevensonDentalSolutions]

I have found it to be much easier on natural enamel with a sharp hatchet.

[@karenmaysuguitan]

where is your isolation?

[@StevensonDentalSolutions]

Check out my rubber dam videos and clinical series.

[@vishalinimuthukumar6771]

Rgs stands for?

[@StevensonDentalSolutions]

Restorative Guide System

[@SmedleyRudolf-w4k]

Young Gary Clark George Martin Nancy

[@soulocclusion]

So beautiful design of cavity, but in real life its working little different...

[@StevensonDentalSolutions]

Yes, it can be even better...every prep, every time, focused on excellence. Larger perhaps due to decay and defects, but equal or better in precision and refinement.