DENTAL CASE #6 | DME AND INDIRECT RESTORATIONS
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- Опубліковано 15 вер 2024
- Hi dear colleagues,
In this video I would like to talk to you about a case where I did DME (Deep Margin Elevation) in combination with three indirect and one direct restoration.
There is a lot of literature about DME. Here are some of the studies I mentioned
1. Magne P., Journal of Prosthetic Dentistry. M-i-M for DME: matrix-in-matrix technique for deep margin elevation
2. Sarfati A., The International Journal of Esthetic Dentistry. Deep Margin Elevation versus crown lengthening: bioligic width revisited.
3. Bresser R.A., Journal of Dentistry. Up to 12 years clinical evaluation of 197 partial indirect restorations with deep margin elevation in the posterior region.
4. Frankenberger R. Clin Oral Invest. Effect of box elevation with resin composite on marginal quality of ceramic inlays in vitro
5. Magne P. Am J Esthet Dent. Deep Margin Elevation: A paradigm shift
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This was the most informative video on DME that ive managed to find so far!! I’m so happy to have found your channel!! Cant wait to learn more from you :)
Thank you so much 🙏
Amazing work doc. Thank you very much for sharing. Wating for more videos :)
Thank you for your kind words
Nice case! Just starting my indirect cases and always learning with you. Feeling myself somehow comfortable about seein that even though DMEs were done retraction cords were still necessary before impression kkk 😅
Truth is: it’s not always easy
Keep posting 👊 🦷 💎
Thank you!!
Beautiful
Thanks!
Amazing video! My Sunday afternoon well spent watching all your videos :) I have a question, temporizing was done with a silicon template of the original situation or free handed? I think it's great that your patient has impeccable hygiene because a lot of similar cases present sometimes where the gums are less than ideal and bleeding is hard to stop with retraction cords. Cementing with flowable is new to me and I'm assuming you used etch and primer bonding etc...did you etch the restorations as well? And removing the excess flowable, it doesn't leave any open margins? Thank you for sharing this next level off the top quality video's! Helemaal geweldig xx
Thanks!!
Yes, the provisionals were made with a putty index that I made before I started my preparation.
For me, patients always have to go to the hygienist first. I’m not doing restorative treatments in mouths with achter periodontal problems and calculus.
Yes, I cemented with heated composite, there is an entire protocol that you need to follow to prepare the tooth and ceramic restoration. If you want to know more about that, check out the Karma. margins course. This two day course will learn you everything about indirect restorations in the anterior and posterior region
Really great Case! Thank you for sharing. Can I ask if you did IDS for the Molars as well as I can see some dentine not covered with comp?
Hi, thank you! Yes I did both IDS and DME. Where do you see uncovered dentin? I wasn’t aware of that 🙈
Great video! Where would you place a wedge to compensate for the rubberdam mesial traction, suppose there was mesial traction? And does the wedge not interfere with your outline so the indirect will not fit correctly?
Thanks, that’s actually a great question. Since I cement these restorations one by one I can always go back and dry fit them again to see if the fit is actually still good. If not I can locally place a wedge. And then remove it after bonding and fit the next restoration again and repeat if necessary. I often trim the wedge with a scalpel blade or bur to remove the top part, it that way you can often place a wedge without interfering. Hope this helps
Amazing case and explanation man!
Thanks Jon, that's actually one of the main reasons to start this UA-cam channel. To give some more background information on the cases I post on instagram.
How did you get the photo with the ceramics floating on the preps.Great Work!
Haha yeah that was tricky! I misaligned them on purpose to get them this way
Hi! Very nice, educative video!
Do you always use black contrastors for shade taking? Is it more reliable with the contrastor than whiteout them?
Hi, thanks! I like it better but I think it also may be more reliable. My dental technician from Kwalident always wants me to take the cross polarized pictures with a black retractor and contrastor
Beautiful work doc! How did u temporize?
Thanks! I should have made a photograph of it, but I used clip to temporarize. It’s a really nice material which you can use
I was going to ask the same.
One more question: No cusp coverage for the second premolar? Since this one has a root canal? And would you use veneerlay preps in some cases, for esthetic reasons ? Or with a very good colour check a veneer lay is not necessary, since you won't see the margin? ( actually 3 questions :) )
Hi Collin, super good question. It's something that I am always wondering about when doing 'crown preparations' on endodontically treated teeth. After removing the old composite both cusps where thicker than 3mm at the base and for me that was enough to leave them as is. But that doesn't mean that it's the right option, I think it also wouldn't have been bad to just cover them. I tend to not do that many veneerlays since they are pretty invasive and invade the biorim of the tooth. I often discuss with my patient that I would prefer to do a partial restoration to keep as much healthy and sound tissue as possible but there might be a change of seeing the margin. It really depends on the location (esthetically), the quality of the tooth (how much healthy tissue is there) and the patient (how critical are they). Hope this helps!
What was the time of spent for the full procedure?, looks really time consuming, but worth it
Hi, it was haha! 180 minutes for the preparation, 90 minutes for the cementation
Beautiful concept !
I just discover your Instagram and UA-cam Channel
What is your photography set up ?
How do you transfer your photos from your photos device to your Instagram profile ?
Hi Tim, I actually made a video about “how I make an Instagram post”. I will upload it this week.
I will also make a video about my photography set-up
@@thedentaldutchman super !!