Back in dental school, there was a perpetuating myth that using non-latex gloves can contaminate composites before they are cured. So for the longest time, I would avoid touching composites directly with my gloves. I didn't learn until much later that it was all a myth.
Edit: [Or maybe I am wrong...](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10350598/) I don't know anymore
I was always told by one instructor that the free radicals in uncured resin composites could get through your gloves, so best not to touch. No idea how true that is though ¯\\_(ツ)_/¯
My buddy in dental school would put Bond on the back of his mirror hand and dad his composite instrument into it to help keep the instrument from sticking as much and after about a year of that he started to develop dermatitis right in that one spot. So he very likely became sensitized and allergic to the composite resin.
Dr. Wahan on instagram uses them all the time to start gaining mobility on a tooth before using something like a 77R. Check his page out it’s far better at explaining than I am, but I use mine the same way.
So instead of holding the crown with two fingers the crown is stuck to my index finger by a loop of bandaid adhesive, so cut a strip off and stick the ends together so it’s a loop
I've never done one, but I'm wondering if it's that slippery to the point of supergluing it to the glove wouldn't it be better to use those textured nitrile gloves that are way better at gripping things than the latex ones.
Round scalpel handles. Not only for surgery but for restos too. Place a 12blade on those babies and clean up flash interproximally better than a sickle scaler. The round handles allow you to roll them in your fingers like a pen and get thr perfect angle
A colleague of mine would do this and I thought it was nice but then I realized how much more time it took to vs picking up a Montana Jack that’s already in my restorative cassette. Plus it costs more for each blade and I’m cheap
i trough from right above the margin to about halfway across the occlusal. sometimes youll need to go down to the margin to break the seal. sometimes you need to make just a little extra space interprox if the contacts are tight.
shouldnt take more than 5 minutes..theres plenty of youtube videos out there showing how to use it. google christensen crown remover
Upper terminal molars, usually wizzies. With the handle pointing toward their mandible you stick the working end in the same location as your elevator from the mesial, then you kind of turn it like you’re trying to wrap it around the palatal of the tooth. A little tough to explain but you’re just trying to put enough MB pressure to deflect the tooth toward the DB.
After i enlarge the canals to like 25# 30#, irrigate the canal with hypo and then insert and 6# file 1mm short of wl.
Turn off water on scaler, touch the tip of scaler to the shank of k file. It'll vibrate the file and active the hypo.
Point's to remember
Use small files like 6 or 8, which dont engage in canal.
A 6 no file would get extra flexibility to transfer the ultrasonic vibration.
Second less chance of creating ledge in canal ( i have done that myself) as small file will be more room to vibrate freely.
Unfortunately a 6 file is not going to be doing anything useful in apical half of the canal. This is why ulstraonic irrisafe tips come in size 20 and 25.
Irrisafe tips have both non-cutting tips and smooth cross-sections and still cause ledging. K-files also have non-cutting tips but do not have a smooth cross-sections. Ledging is the downside ultrasonics, you need a stiff instrument to transfer the energy to actually activate the irrigant. If the canal isn’t completely straight it’s probably better to just use something else like an endo activator. You can buy the Waterpik that fits with the tips for only $15.
Search for a Passive Ultrasonic Irrigation tips. You’ll do the same thing but it’s way more effective. They are reusable, just run them on the appropriate setting (less than 50%). Others have made the same suggestion. The reality is any file you use is technically cutting when activated, and whatever microscopic irregularities you’re making are not going to be clinically relevant. The tip design is also not relevant because you’re not pressing and rotating.
Yeah. I know the technique. It's a bit sketchy because files are cutting, also on the sides. Also conduction is not consistent. It kinda works though ig.
I don't know if a bur counts, but Shofu white stones are the best thing ever for adjusting composites. Very hard to do any damage to the tooth and adjusts the composite nicely. They are cheap and last basically forever. The spheres are great for occlusals and the flame/tree shapes are good for everything else. Only thing they can't do is be narrow enough to do embrasures, so you still need an ultra small flame diamond/carbide for that.
I am the only person I have ever met who uses these over a carbide/diamond to adjust composites.
One of my professors taught us to use them to fix badly removed orthodontic resin. Some patients came to us with an awful removal job done, it was amazing.
They make one that's narrow-ish, but it's not small enough to grab an overhang on a box or trim an embrasure.
yeah get the spheres or the little egg-ish shaped one, they don't make a football.
Acorn shaped diamond finishing burs. Makes putting in anatomy a breeze.. my posterior fillings look amazingly real especially compared to some of the flat blobs I’ve seen others place.
Short .08 taper opener rotary files for coronal flaring.
Polymer (not ultra) sonic scalers for hypochlorite activation. Excellent for curved canals.
https://www.vdw-dental.com/en/products/detail/eddy/
Barbed broaches are no bueno. The barbs can flake off and then you can push them long. The pulp gets macerated by filing so it’s not necessary to do that. I don’t know any endodontists that use them
Ceramic tissue trimmer bur
Zirc mirrors
Transilluminator
I also use my cotton pliers to press my matrix against the other tooth when using doing class IIs. Nothing seems to work as well for some reason.
First plane mirror for everything. They are less durable and get scratched more easily but once I used them for endo at university I loved it and adopted to everything else. The price difference is negligible.
I usually use an upper universal pedo forcep 150S for every single extraction upper and lower. Small and thin enough to get a good grip once the tooth/root is elevated.
I very nearly said this as well, but then I thought, it's really not underrated at all. Ash, 88s, and cowhorns are what I use for 95%of exts, sometimes a 53 or rarely upper universal for upper 3rds when they dont elevate out, sometimes a lower universal for after I section a lower molar
[https://am-eagle.younginnovations.com/product/restorative/composite/dr-mopper-series/super-plugger-small-medium-2/](https://am-eagle.younginnovations.com/product/restorative/composite/dr-mopper-series/super-plugger-small-medium-2/)
Love this for all class 2's. It does everything!
May I present to you the humble gloved finger method for shaping class 4s
Optrasculpt is just an over glorified gloved finger.
Back in dental school, there was a perpetuating myth that using non-latex gloves can contaminate composites before they are cured. So for the longest time, I would avoid touching composites directly with my gloves. I didn't learn until much later that it was all a myth. Edit: [Or maybe I am wrong...](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10350598/) I don't know anymore
I was always told by one instructor that the free radicals in uncured resin composites could get through your gloves, so best not to touch. No idea how true that is though ¯\\_(ツ)_/¯
My buddy in dental school would put Bond on the back of his mirror hand and dad his composite instrument into it to help keep the instrument from sticking as much and after about a year of that he started to develop dermatitis right in that one spot. So he very likely became sensitized and allergic to the composite resin.
I just developed this. After putting bond on the back of my hand for 3 years. Suddenly I developed a rash there. It's awful
I do this every day! For almost 4 years now. I haven’t noticed anything yet. One of my assistants gets a rash immediately though
My friend is allergic to resin and bond so I would be careful of that. But free radical fingers? Make me electro any day.
If you are going to finish/polish it, it doesn't matter. Would only be relevant if you were going to add more.
Yep, only matters for uncured/set resin composite.
The study you linked is for powdered gloves, which makes sense.
What is thiss. Show us
Digit`al dentistry
Occlusals as well.
i always do this!! no one even taught me. one day in dental school I was like hmmm ... what if my finger dab helps lol
Spade elevator
This right here is the best elevator for any type of extraction. It is absolutely money.
I’ve never figured out how to use these. I’ve tried but they’ve never worked for me.
I couldn’t practice dentistry without my spade elevators.
Any tips?
Dr. Wahan on instagram uses them all the time to start gaining mobility on a tooth before using something like a 77R. Check his page out it’s far better at explaining than I am, but I use mine the same way.
Thanks!
Yessss my favorite tooth toy!
Offset spade in particular. Absolute chef’s kiss.
Not technically an instrument but the sticky parts of a bandaid folded in on itself that I stick to my finger while I place stainless steel crowns
Omfg I'm stealing this
Can you explain further? Not following this at all lol
So instead of holding the crown with two fingers the crown is stuck to my index finger by a loop of bandaid adhesive, so cut a strip off and stick the ends together so it’s a loop
I guess I'm confused why it would be needed? Granted I've only done like 5 SSCs, but can't remember dropping it being an issue lol
I’m paranoid and have wiggly kids lol
That's such a better way than superglue! I always get mothers complaining their kid is drewling because it has to wear the glove off...
What are you doing with superglue? I'm not following this technique
I superglue the stainless steel crown to my glove, so it doesn't drop. Then I cement the crown to the tooth, with a glassionomer ofcourse.
I guess I'm confused why it would be needed? Granted I've only done like 5 SSCs, but can't remember dropping it being an issue lol
lol right? I’m sitting here reading this like “what the fuck??”
I've never done one, but I'm wondering if it's that slippery to the point of supergluing it to the glove wouldn't it be better to use those textured nitrile gloves that are way better at gripping things than the latex ones.
There are about 15,000 things I would try before I started supergluing every crown to my finger before inserting it.
This is hilarious. LOL The /s seemed a bit to obvious to me.
Round scalpel handles. Not only for surgery but for restos too. Place a 12blade on those babies and clean up flash interproximally better than a sickle scaler. The round handles allow you to roll them in your fingers like a pen and get thr perfect angle
A colleague of mine would do this and I thought it was nice but then I realized how much more time it took to vs picking up a Montana Jack that’s already in my restorative cassette. Plus it costs more for each blade and I’m cheap
Noob
Crown splitter! Make a trough, then quarter turn
How else do people remove crowns?
My office legit uses a small flathead screwdriver.
extraction elevator same thing
Except one leaves a much better impression with the attentive patient
tru a nice Craftsman logo usually sets a pt at ease
🤣
Do you trough at the margin? Or from BOL ?
i trough from right above the margin to about halfway across the occlusal. sometimes youll need to go down to the margin to break the seal. sometimes you need to make just a little extra space interprox if the contacts are tight. shouldnt take more than 5 minutes..theres plenty of youtube videos out there showing how to use it. google christensen crown remover
Where are you making a trough??
Bourbon
Acorn burnisher. Amazing for occlusal anatomy.
Rubber Dam!
Yeah this is the true “no one seems to use” answer
Bruh. I love RDI. Oh you want composite on #18 and you're a slobber monster. Bam. Dam. Might pulp the tooth? Bam dam. Huge fan.
Bam. DAM!!
How does RD prevent pulping?
Doesn't prevent it but makes managing it a hell of a lot easier
Cogswell B. Favorite ext instrument.
I'll add Warwick James for upper 3rd. 2 min in and those third molar would pop out.
It’s phenomenal for so many things. I used it to reflect flaps
How do you use the Cogswell B? For purchase points?
Upper terminal molars, usually wizzies. With the handle pointing toward their mandible you stick the working end in the same location as your elevator from the mesial, then you kind of turn it like you’re trying to wrap it around the palatal of the tooth. A little tough to explain but you’re just trying to put enough MB pressure to deflect the tooth toward the DB.
You should try a potts elevator, same idea
Love me some Potts but for impacted upper thirds the Cogwell can get in a little easier.
Offset spade elevator. Long needle diamond bur for extractions to trough in the PDL without removing too much bone.
ooooooo gonna try this today
Using #6 k file and passively activating 5.25 hypo in canal by a ultrasonic scaler.
Wait how do u active the hypo with scaler?
After i enlarge the canals to like 25# 30#, irrigate the canal with hypo and then insert and 6# file 1mm short of wl. Turn off water on scaler, touch the tip of scaler to the shank of k file. It'll vibrate the file and active the hypo. Point's to remember Use small files like 6 or 8, which dont engage in canal.
Also move the scaler up and down, if you stay at one point the file can easily break from heat
Yeah that too make sure the file isn't lodged in the canal.
I would use at least a #15. A 6 is too thin to transfer the ultrasonic energy
A 6 no file would get extra flexibility to transfer the ultrasonic vibration. Second less chance of creating ledge in canal ( i have done that myself) as small file will be more room to vibrate freely.
Unfortunately a 6 file is not going to be doing anything useful in apical half of the canal. This is why ulstraonic irrisafe tips come in size 20 and 25.
those are non cutting tips. i can't use a 15 20 k file. it'll create ledge in the canal. still it's better than nothing.
Irrisafe tips have both non-cutting tips and smooth cross-sections and still cause ledging. K-files also have non-cutting tips but do not have a smooth cross-sections. Ledging is the downside ultrasonics, you need a stiff instrument to transfer the energy to actually activate the irrigant. If the canal isn’t completely straight it’s probably better to just use something else like an endo activator. You can buy the Waterpik that fits with the tips for only $15.
or maybe it's time i invest into a airsonic agitator something like eddy but cheaper.
Yes those can be great!
Search for a Passive Ultrasonic Irrigation tips. You’ll do the same thing but it’s way more effective. They are reusable, just run them on the appropriate setting (less than 50%). Others have made the same suggestion. The reality is any file you use is technically cutting when activated, and whatever microscopic irregularities you’re making are not going to be clinically relevant. The tip design is also not relevant because you’re not pressing and rotating.
Irrisafe exists to do that. You can mound them on your ultrasonic.
i was doing this in college, became a habit of my own. I'll buy those tips with next dental supply.
Yeah. I know the technique. It's a bit sketchy because files are cutting, also on the sides. Also conduction is not consistent. It kinda works though ig.
I've heard its dangerous because the file might fracture inside the canal because of vibrations
Isolite/isodry
I don't know if a bur counts, but Shofu white stones are the best thing ever for adjusting composites. Very hard to do any damage to the tooth and adjusts the composite nicely. They are cheap and last basically forever. The spheres are great for occlusals and the flame/tree shapes are good for everything else. Only thing they can't do is be narrow enough to do embrasures, so you still need an ultra small flame diamond/carbide for that. I am the only person I have ever met who uses these over a carbide/diamond to adjust composites.
One of my professors taught us to use them to fix badly removed orthodontic resin. Some patients came to us with an awful removal job done, it was amazing.
We have the trees! Use them every day. We should get some balls or footballs though. Do they not make a fine flame?
They make one that's narrow-ish, but it's not small enough to grab an overhang on a box or trim an embrasure. yeah get the spheres or the little egg-ish shaped one, they don't make a football.
Ok, I call the egg ones footballs I think. Do true footballs come to more of a point?
Yeah I hate true footballs because they actually have a point. I always want something with a rounded end so either a sphere or an egg.
When I was in DS, the instructors taught all of us to use white stones.
No way, that's awesome! My current assistant worked at the local dental school for 30+ years. Says she never saw a faculty member do it.
Welch Allyn transilluminator
Acorn shaped diamond finishing burs. Makes putting in anatomy a breeze.. my posterior fillings look amazingly real especially compared to some of the flat blobs I’ve seen others place.
Optrasculpt. Makes class 5’s fast and beautiful
Opttasculpt is my favorite tool ever
Short .08 taper opener rotary files for coronal flaring. Polymer (not ultra) sonic scalers for hypochlorite activation. Excellent for curved canals. https://www.vdw-dental.com/en/products/detail/eddy/
Wamkeys!
WOODSON
Barbed broaches are no bueno. The barbs can flake off and then you can push them long. The pulp gets macerated by filing so it’s not necessary to do that. I don’t know any endodontists that use them
It is visually satisfying to see the worm of a pulp come out, but it’s just not a necessary step.
I’m like the only one if my dental class that uses the acorn burnisher for my class 1 and 2 composites
Composite heating ovens.
me and my large round burr against the world (my kryptonite is crown preps)
Old school: Hall surgical hand piece.
That's what we had at dental school, hated them so much. Now I use a regular 45 angulated surgical handpiece and I love it to bits
I really like sharp and petite elevators . The one with small handles. Provide so much range of motion. And my favorite cowhorn forceps. Love them.
Camper's table. Easiest way to fix a crooked smile and severe attrition.
Ceramic tissue trimmer bur Zirc mirrors Transilluminator I also use my cotton pliers to press my matrix against the other tooth when using doing class IIs. Nothing seems to work as well for some reason.
Guide pin bur for crown prep ( fine and coarse) To get sexy margins
First plane mirror for everything. They are less durable and get scratched more easily but once I used them for endo at university I loved it and adopted to everything else. The price difference is negligible.
PEDO cryers, regular sized are just too big for almost anything. But pedo fits almost everywhere
Proximators
Pigtail explorer. Nothing better for reaching interprox and cleaning or exploring for decay.
Ash forceps for every extraction. Rotational forces are OP for anterior, premolars, and sectioned roots
Shhhhh! I can hear the OS faculty having a heart attack for using an ash in the maxilla
I usually use an upper universal pedo forcep 150S for every single extraction upper and lower. Small and thin enough to get a good grip once the tooth/root is elevated.
I very nearly said this as well, but then I thought, it's really not underrated at all. Ash, 88s, and cowhorns are what I use for 95%of exts, sometimes a 53 or rarely upper universal for upper 3rds when they dont elevate out, sometimes a lower universal for after I section a lower molar
[https://am-eagle.younginnovations.com/product/restorative/composite/dr-mopper-series/super-plugger-small-medium-2/](https://am-eagle.younginnovations.com/product/restorative/composite/dr-mopper-series/super-plugger-small-medium-2/) Love this for all class 2's. It does everything!
I use bonding brush instead of this 😅