25:25 (31:41) Incisal Attrition and Wear
Realtime Real Patient Treatment Videos
General Overview for Incisal Attrition and Wear
This is a very common restoration. It's a great opportunity to perform to open the door to discussing several oral health issues. Talking with the patient about this with their before and after pictures can go a long way to helping them understand what they otherwise might not about their need for a night guard or other treatments.
Step By Step
Trough out rough enamel and friable dentin on the incisal edge to create space for resin
Note: 2 suctions, High-volume and Salivajector, using the mirror to deflect.
Create a slight bevel with a 6-fluted bur.
This is a good point in the treatment to take an impactful “before” photo
Remove any thin, unsupported enamel.
*Note: 2 suctions for isolation*
Following the total etch technique, apply phosphoric acid gel.
Rinse using suctions.
Dry off, then, using a disposable multibrush apply Danville microprime, desensitizing and antibacterial. Take care to keep it off soft tissue.
Apply 5th generation Scotchbond to the dried area.
*Tip: Blow on the mirror to ensure no moisture remains in the A/W syringe prior to using it to dry.*
Apply opaque Beautifil A20. Using opaque resin provides better appearance due to lack of shine-through.
Tease in with explorer, being sure to remove air bubbles.
Cure
Bulk reduction of incisal surface. Remove bulk with Brassler ET6 Multi-fluted football polisher.
Clean up the lingual
Get down to bevel, not removing any tooth
Remove flash with Montana Jack scaler
Break contact. Here, as in so many bonding procedures I've performed, I use a Horico smooth stainless steel serrated separating strip.
Floss to remove loosened flash
Polish with ET 12-fluted football bur for enamel-like finish using a feather touch
Polish with Brassler Orange extraafine Dialite diamond polishing cup. Truth is what the patient's tongue feels, so polishing matters.
Rinse and dry
Finish by presenting the patient with a final “After” photograph of the beautiful result
Look at occlusal trauma
Relieve interferences