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In addition to using it for diagnostic protocols, we frequently employ the electric waxer at the office when a patient breaks a tooth. The assistant takes an impression, pours the impression in quick-set stone, and then uses the waxer to restore lost tooth shape before making a matrix in which to make the provisional restoration. It is a customized, fast, and easy technique.
To be in control of the atraumatic extraction procedure, I have found the most efficient instruments to be those that focus all the work on the roots. These instruments are able to navigate the periodontal ligament (PDL) space and sever the ligament while slightly expanding the socket, which is the first step.
As you enter the PDL space, you cut the ligament as you feel for an advantage in leverage on the root surface. Once you feel resistance, you then push the root and nudge it with a slight twist. If the root moves, you can then work deeper into the PDL space with the same motions and dislodge the root, or move to another location on the root and repeat. The “cut & feel, push & nudge” technique is the same for every tooth; for multi-rooted teeth, I loosen first then section, if needed, and then work my instruments on the sectioned roots.
Reader Tip of the Month
Prior to preparing a crown or three-unit bridge, I take a “Triple Tray” bite relation with Blu-Mousse to help fabricate a temporary. Once the tooth/teeth are prepared, I fill the Triple Tray with Luxatemp material and reseat the impression in the mouth. This establishes the previous anatomic form, which I can modify, and establishes the prior occlusion. When I start to characterize the temporary, the occlusion is already perfect, the contacts are already perfect,
and the margins are already perfect. Contouring is quick and easy and no adjustments are necessary after cementing the temporary in the mouth.
Marc Herman, DDS
Advanced Dentistry of Long Island
Woodbury, New York
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