Class III Composite Restoration #9 DL FIll

[@fanzhang02]

It is really amazing. Thank you so much for posting this Video. Huge help! ❤❤

[@StevensonDentalSolutions]

My pleasure! Dr. Stevenson

[@stephaniejee138]

What a welcome diversion from the PPE hunt! So glad to have participated in your UOP boot camp last year. Thanks for the content! Stay safe and well!

[@StevensonDentalSolutions]

Great to receive this message! All the best, Dr. S

[@StevensonDentalSolutions]

Awesome! Thanks

[@muhammaddamlakhi5128]

You are the master of composite wow how you save the shape of tooth

[@StevensonDentalSolutions]

Thank you!

[@idfsoldier101]

Hi Dr. Stevenson, what drill speed do you use when polishing? Thanks for the great video?

[@StevensonDentalSolutions]

20,000 rpm

[@rahulg1156]

Great video Doctor!!

[@StevensonDentalSolutions]

Thank you Rahul

[@쵸니-p7w]

Hello doctor. I like your #9 DL filling (your title says ML tho). Thank you for your video. I really appreciate them all!! :D

[@StevensonDentalSolutions]

Fixed it. Thank you!

[@israfilekiz2288]

Alidali andim pile aminiyi

[@israfilekiz2288]

Doktor damlik iflsididi am sendegal sevdim seniniiiiiidafil bidemi sencok guzel ozelsin

[@scottsdaledentistprincessc4744]

Great video, nice composite placement

[@StevensonDentalSolutions]

Thank you Doctor

[@kevinpham3087]

Looks good doc.

[@StevensonDentalSolutions]

Thank you Kevin.

[@angelacheong3623]

Dr. Stevenson, what burs would you recommend to use for adjusting occlusion ? Thank you.

[@StevensonDentalSolutions]

7404 and 7404-F

[@dalia4014]

Thank you so much Dr Stevenson for the great video my question is about how to protect the adjacent tooth while performing the polishing and finishing of the composite Thanks

[@StevensonDentalSolutions]

Usually the discs are safe sided, meaning than one side has no grit and this won't damage the adjacent tooth. The abrasives can damage the adjacent plastic tooth (not enamel) is over-worked, so be careful.

[@dalia4014]

@@StevensonDentalSolutions Thank you so much Dr Stevenson

[@mohadz48]

thank you

[@StevensonDentalSolutions]

My pleasure!

[@laurenSmith-bf4fc]

How long does the feeling last on the front teeth?

[@StevensonDentalSolutions]

it should feel better immediately after finished.

[@shockwave208]

If this were a real tooth on a patient, would you still not light cure the adhesive?

[@StevensonDentalSolutions]

I would light cure the adhesive as per the manufacturers instructions with a calibrated light.

[@shockwave208]

@@StevensonDentalSolutions Of course. Any tips on getting the composite to be more "flowy/glossy"? I've heard mixed things about using adhesive for that purpose. What are your thoughts?

[@rozea.6385]

İt was very helpful:)

[@afrozekhan2269]

Hello Dr, You mentioned not to use carbides and diamonds on the anteriors. Can we use finishing carbides and finishing diamonds?

[@StevensonDentalSolutions]

Yes but be extremely careful to not damage the plastic surfaces of the adjacent areas. All the best, Dr. S

[@afrozekhan2269]

And what about finishing stone? Do they also damage the surrounding areas?

[@StevensonDentalSolutions]

@@afrozekhan2269 If used carefully, no, they are fine.

[@afrozekhan2269]

@@StevensonDentalSolutions thanks so much

[@jamesf3583]

does the snowplow effect only apply to the specific adhesive and composite you used? I use prime and bond and not a bulk fill resin. Assuming you were using a bulk filled resin in the video

[@StevensonDentalSolutions]

This technique is ONLY for plastic teeth and it works well, but I would never use this for routine patient dentistry, except in very conservative class II fillings, following the Clark Technique in all respects. Curing completely with a non-bulk compsoite is under risk, but it is quick and works well for plastic teeth exam situations. I don't use bulk fill in any form on patients. Total etch, followed by two separate adhesive steps (priming and bonding) is the Gold Standard

[@skarlettmoran3970]

EXCELLENT! ECUADOR

[@StevensonDentalSolutions]

Thank you

[@jquin3]

Whats the reason for not precuring the bonding agent prior to placement of the composite?

[@StevensonDentalSolutions]

Please rewatch the video - I describe the snow plow effect

[@lannyrubin2600]

Forgot to ask you the other day. I have been using a #12 disposable scalpel to remove flash. Being they cannot be autoclaved I decided to go with regular scalpel blades that are 100/box. and autoclavable handles, Which blade would you suggest for the flash removal. Carbon or stainless steel. As always, thank you for your wisdom I appreciate your help.

[@StevensonDentalSolutions]

Carbon steel is amazing - they keep their edge longer. Very cool question! All the best, Rich

[@santinotestani]

I love you

[@StevensonDentalSolutions]

Thank you!

[@larryrizzo736]

Dr. Stevenson, I have a question about your omitting bevels along the cavo surfaces of your preparation. Won’t that minimize the exposure and filling of enamel rod spaces with bonding material?

[@StevensonDentalSolutions]

Good question. Actually we’ve been teaching to not use bevels on the lingual side of class 3a at UCLA for many years and I we are not alone. The major licensing boards in the US do not require them either. The issue is that the beveled thin composite area may in fact lead to microfractures if the occlusion is going to hit in this particular area. Bevels on the lingual don’t really assist you much because the retention with the amount of enamel that’s existing is sufficient. However on the facial where you wrap around the inner proximal you’re going to want to place bevels for aesthetic reasons to blame the composite into the unprepared surface. We don’t bevel the occlusal surface of class I or class 2 composite restorations either and this is done for the same reason.

[@dominickdolecki7967]

What shade did you use for this? Blends in well. Thank you

[@StevensonDentalSolutions]

Filtek Supreme Ultra (3M) A2 Body

[@israfilekiz2288]

Fil (2) mame tenim diblekami iyi

[@omargad7494]

Awesome as usual doctor! What other classes does the"snow blow effect" apply to? Class 5? And what do you think about applying 2 coats of adhesive in class 1 or 2?

[@StevensonDentalSolutions]

The Snowplow technique, also called injection molding, applies to class II Preps most of the time. It certainly can work for other classes like class five but it’s main purpose is small class twos and small class threes. Applying multiple coats of adhesive is a great idea to make sure that you have a complete seal.

[@undagr0undvibes]

Our dental school has us do the following steps for class III composite fill: 1) apply universal bond & air thin 2) add composite (A2 enamel) in layers & cure in between 3) carbide football/treetop burs to finish 4) satin point polisher bur to polish I have to agree that the carbide burs make my finish look rough & they flatten out my marginal ridge (especially when using the football) 1) not sure if I’m grasping the concept correctly but does the snowplow effect only work if you kept the bonding agent untouched? 2) after you shaped the composite with the Mylar strip & light cured, I noticed the composite was already extremely shiny without any polishing - is this because of the body composite you used? Or due to the bonding agent getting pushed outwards from the snowplow effect? When we use A2 enamel, it doesn’t look anywhere near as shiny Thanks so much for reading!

[@StevensonDentalSolutions]

The snowplow is only used for exams - not for patients unless you strictly follow the David Clark technique. This technique works great for typodont teeth. Displacing the flowable without any curing until displaced works incredibly well for these exam situations. We etch then use Universal - far better results with enamel bonding, than simply self-etching. The shiny surface is due to the band - no air inhibited layer.

[@ramboride2674]

is finishing carbide football shape okay to use?

[@StevensonDentalSolutions]

Not a good idea unless you plan to spend more time on polishing...

[@poeticdentist]

@@StevensonDentalSolutions Hello Dr. Stevenson, could you please explain why shouldn´t we use finishing diamonds on composite? I study at the dental school in Germany and this is standard process before moving to polishing discs (Super Snap + Super Buff). I´m trying to perfection my routine though and would appreciate some advice. Thank you in advance.

[@poeticdentist]

Talking about work on a real teeth of course, not plastic :-)

[@sanapalaadithya9745]

Hi sir why not carbide bur etchant and primer is used?

[@StevensonDentalSolutions]

1. Carbide burs do not penetrate the hard outer shell easily. ( i mentioned this in the video) 2. No need - it's an artificial tooth - no dentin to bond to and the enamel on this tooth will not etch.

[@sadigguliyev4045]

Thank You