Using Innovative Carbide Instruments
Delivering quality restorative dentistry with high-quality, multi-functional precision burs.
Tamara L. Bailey, DDS
In today's economy, dentists are continually searching for more efficient means to deliver quality dentistry to their patients. One method of achieving this goal pairs quadrant dentistry with the use of superior-quality rotary instruments and materials. Some patients have difficulty scheduling multiple appointments; however, by performing quadrant dentistry, dentists can minimize a patient's time away from work and increase efficiency in the dental office.
When performing quadrant dentistry, one method of reducing chairtime is to use quality rotary instruments that serve multiple functions. Using high-quality precision burs can minimize actual preparation time; using multi-functional burs and minimizing the number of bur changes per procedure can further reduce chairtime. This article will demonstrate the use of KOMET USA's Q-Finishers® (http://www.komet-usa.com).
Quality, Multi- Functional Carbides
Until now, working on composite fillings required three or more finishing steps using normal, fine, and ultra-fine finishing instruments. Additional pastes and polishers were sometimes used. With the development of Q-Finishers innovative toothing, the procedure can now be reduced to just two steps. KOMET USA's Q-Finishers (Figure 1) are time- and cost-saving instruments because at least one step is truly eliminated. In the author's opinion, a better surface quality after initial restoration placement is now easily attainable because of the Q-Finishers cross-cut toothing.
Q-Finishers are cross-cut carbide burs designed to work on composites. With the innovative Q-Finishers, the finishing procedure can now be reduced to two steps, using the Q-Finishers for the first step and the ultra-fine finishing bur for the final step. In addition, the fine tapered H134Q and H135Q Q-Finishers ensure a gentle finish along the gingival margin as they have a smooth non-cutting tip. Additional polishing steps and pastes are usually not required. The clinical examples in this article will demonstrate how two specific Q-Finishers allowed the author to complete each procedure in a short period of time yet provide high-quality, enduring restorations.
Clinical Example 1
A patient presented to the office for restoration of teeth Nos. 19 and 20. After anesthesia was administered, gross caries removal was achieved using a No. 4 round carbide bur (KOMET USA). Figure 2 shows the initial preparation after complete removal of carious dentin. After complete caries removal, a one-step bonding agent (Brush&Bond®, Parkell, Inc, http://www.parkell.com) was applied and cured (Ultra-Lume® LED 5, Ultradent Products, Inc, http://www.ultradent.com). Layers of composite (GRADIA® Direct, GC America, Inc, http://www.gcamerica.com) were placed and cured incrementally. Figure 3 shows the teeth immediately after gross placement and curing of composite material.
To complete the restoration, a football-shaped Q-Finisher (H379Q.FG.018) (Figure 4) was used on the occlusal surfaces of the teeth. Final finishing of the composite was achieved by using the ultra-fine, football-shaped Q-Finisher (H379UF.FG.018) (Figure 5), providing a final restoration (Figure 6) that satisfied both the practitioner and the patient.
Clinical Example 2
A patient presented to the office requesting improved esthetics on her upper anterior teeth (Figure 7). She was unhappy with the staining around the existing restorations as well as the spaces between the teeth. After discussing all of the options including orthodontics, porcelain veneers, and chairside composite restorations, the patient elected to have composite restorations placed. Without orthodontics and/or crown lengthening, the patient understood that complete closure of all her diastemas was not possible and would make her smile esthetically unappealing.
The patient elected to have the procedure performed without anesthesia. The existing restorations and recurrent caries were removed using a No. 4 round carbide bur (KOMET USA). The enamel was recontoured as needed, providing proper esthetics and allowing for adequate thickness of material. A crown-preparation carbide (KOMET USA) was used to prepare the surface for composite veneers.
To complete the restorations, the first step of finishing was achieved using a KOMET fine tapered, non-end-cutting finishing bur (H48LQ.314.012) (Figure 9). A second polish was achieved using a Q-Finisher (Figure 10). Not all of the diastemas were closed to achieve a more natural, non-restored appearance.
Both posterior restorations were completed in less than 30 minutes by using KOMET USA's Q-Finishers. The anterior restorations, while taking much more chairtime, provided excellent esthetics chairside, which made the procedure affordable for the patient.
This article contains examples of delivering efficient, quality dentistry to patients. Saving on chairtime and minimizing the expense of multiple supplies and/or laboratory expense is important so dentists can thrive in this economy. By simply using quality materials and rotary instruments, such as KOMET USA's Q-Finishers, chairtime is reduced and a finely polished restoration is achieved quickly and efficiently.
About the Author
Tamara L. Bailey, DDS