Class II composite restoration (1) - Slanting/oblique incremental technique (#16) - Arabic عربي

[@romasror374]

ايه الاناقة دي ما شاء الله تسلم ايدك ❤

[@drafnanoalzain]

شكرا تسلموا 🌹

[@DoctorAj2023]

Beautiful explained doc may in ask two two questions First how to make sure that i will have a contact with neighbouring tooth especially i am using toffelmaire band not scetional band and second what are the criteria to choose the appropriate wedge to avoid proximal concavity hopefully you make a video of how to choose the right wedge and when we need to adjust it accordingly thank alot

[@drafnanoalzain]

Thank you. For the first question: by burnishing the band prior to placement you create the needed concavity with the neighboring tooth. Then you place it and see if you did enough burnishing or more burnishing is needed. When placing amalgam you can actually press the amalgam with the condenser against the neighboring tooth to ensure a proper contact. When using composite you cannot press against the tooth so you need to make sure the band is properly burnished. For the second question: visually you can initially select the wedge size according to the embrasure size, if the embrasure is small, use a small wedge and vise versa. Also, if you try to place the wedge and it does not get inserted in the embrasure it means it is large. If the wedge passes through and most of it gets out the other side and is not stable, then it is small. The proper wedge size is that when the wedge is inserted almost the same amount of wedge shows on both sides of the tooth and is stable. Sometimes double wedging is needed by inserting one wedge from each embrasure. I will add the wedge size to the list of videos to create.

[@DoctorAj2023]

@@drafnanoalzain thanks alot doc …. What you think of the concept of trimming the upper edge of the wedge if its higher than the gigival seat of the prep what i usually check and correct me if i am wrong ( fitnees / seal / height and width ) i adjust length is i see it too much high bcz it will push contact to occlusal / if is below gingival seal …. Select higher wedge / width …. If i see a gap between tooth and wedge i trimmed it to match tooth convexity …. All of this is basically just to minimize finishing ….whats your thoughts

[@drafnanoalzain]

@@DoctorAj2023 that excellent. You are customizing the wedge according to the embrasure shape, fit, width and height 👍🏻

[@mohamedshandy4680]

شغل جميل جدا يا دكتور ربنا يكرمك بنتمنى حضرتك تعلمينا ازاى نركب الماتركس والباند في فيديو والفيديو التانى ازاى نعمل كافيتى بريباريشن للكمبوزيت كلاس وان وتو انتى مشكوره شرحتى الكافيتى بريباريشن للامالجم مستنيين نزيد من علمكم في الكلاس تو بريباربيشن كومبوزيت وخصوصا ان نادرا لما حد بيشرح النقطه دى ديمو ومش عارف السبب الحقيقي لكن شرحك المبسط الجميل روعه وعاوزين كل حاجه ناقصانا نفهمها من شرحك

[@drafnanoalzain]

ممتنة لك شكرا. فيديوهات matrix band حتنزل بإذن الله بعد أسبوعين. لسة بأعمل له editing. وفيديو كلاس ٢ كمبوزيت موجود آخر فيديو في مجموعة cavity preparation playlist واللينك تبع الفيديو class II composite cavity preparation موجود في description تحت الفيديو. ولكن الشرح بالتفصيل كيف يتعمل في فيديو ال amalgam. الفرق الأساسي بين cavity for amalgam and composite are the dimensions of the cavity and bur used. غير كدة نفس الطريقة. Comparisons between cavity for amalgam and composite: Amalgam cavity: Bur used: carbide straight fissure bur or no. 245 carbide bur. Width: 1/3 intercuspal distance. Depth: 1.5-2 mm. Retention: buccal and lingual walls converged occlusally. Line angles: rounded. Proximal box: inverted truncated cavity design. Composite cavity: Bur used: no. 330 or no. 245 carbide bur. Width: 1/4 intercuspal distance. Depth: 1-1.5 mm. Retention: buccal and lingual walls slightly converged occlusally, and depends on bonding. Line angles: rounded. Proximal box: in clinics, no need to open the contact buccal and lingual (no need to have buccal and lingual clearance) if all the decay is removed. And we can round the enamel portion of the gingival margin if no decay is left to preserve enamel. وبالتوفيق يارب

[@omaromar11234]

Dr afnan, no matter what I do, their is also excessive high spots that takes me forever to remove them. On the other side sometimes the restoration is so underfilled.. I can't reach an average spot What should I do? Also, composite restorations takes extensive takes extensive time from cavity prep to filling and final finishing,, I normally take from 1h to 1:30h for a single filling of a complex fairly deep cavity(most of my cases are like this).. I wash I could know what I'm doing wrong after all these years??

[@drafnanoalzain]

Hello, did you try to check the occlusion before you start preparing the cavity? There are also other things that can help you: 1. First step is to check occlusion before you start to restore the restoration to its original shape. 2. Keep your cusps, cusp slopes, marginal ridge, neighboring tooth as your guide. A. Place the plastic instrument in about 45 degrees, meaning you tilt it so it is resting on the cusp slope, and then tap the composite then drag the instrument so the composite would drag from the center to the tooth to make sure the margins are closed and the excess is removed. B. The cusp tips and shape of the neighboring tooth can help you as well not add too much on the tooth you are restoring. C. The marginal ridge of the same tooth and neighboring tooth also acts as a guide to shape the height of your margins. D. When checking the occlusion after you finish, press a little during removing of the excess to remove the high points, too little pressure will take longer time to adjust the occlusion. I use to remove so little in the beginning as well and it took me over 15 min just to adjust occlusion. Then I learned to remove more by applying more pressure but not too much that it would result in deficiency. Try this and I’m sure your technique will improve. Larger restorations take time, it’s normal. You can try using bulk-fill composites because you can apply them in small increments up to 3-4 mm and then bulk cure it. It will save time as well. Let me know what happens after you try it. If it still doesn’t work send me a DM on instagram @afnanalzain and I’ll record a short clip for you

[@omaromar11234]

@@drafnanoalzain thank u so much, The problem lies in that at some point I start to lose where the tooth and where the composite is? I work with a 4x magnification and a proper light but still having trouble with this issue

[@drafnanoalzain]

@@omaromar11234 by doing the pulling motion between the composite and the tooth you will remove the excess composite. See min 12:35. I placed the plastic filling instrument in an angle and doing a tapping then pulling motion to remove the excess. Try it again and let me know.

[@omaromar11234]

@@drafnanoalzain I do this oftenly then blend everything after that with a micro brush, it works sometimes but in extensive restoration (most of my work) high spots are such a nightmare

[@drafnanoalzain]

@@omaromar11234 if the occlusal surface is not destructed, did you try to use the stamp technique? It saves a lot of time.