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Figure 29: Toward the end of the preparation
sequence, when most of the gross reduction
has been done, I need to be able to visualize
what I am doing at the margin. I turn off the
water to my KaVo ELECTROtorque handpiece
(KaVo Dental; Charlotte, N.C.), turn the speed
down to around 3,000 rpm, and slowly take
my 856-025 bur back and forth across the
margin, smoothing it out. With the water off, I
can see everything I am doing, and by turning
the rpm down low, I can keep from overheating
the tooth. Being able to run a handpiece at
low speeds with no water and high torque
is the number one reason I insist on using
electric handpieces.
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Figure 30: I notice we still have some decay
on the mesial of tooth #8, so I remove that now
with some Sable Seek ® and Seek ® Caries
Indicator (Ultradent) and a small round bur. I find
it easier to remove any remaining caries at the
end of the preparation sequence rather than at
the beginning, mainly for better access to the
lesion itself, but also because I find I can do a
better job with the bonding steps when I have
better access.
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Figure 31: I have intact tooth structure on all
sides of the carious lesion, so I have a high
degree of confidence about the retention of
this small composite filler I am doing to restore
this (Vertise Flow [Kerr Corp.; Orange, Calif.]).
Vertise Flow is a self-etching flowable composite
that is perfect for small situations like this.
Because it is a self-etching product, there is no
separate etch and bond step. Vertise Flow also
works very well for small Class I restorations,
sealants, preventive resin restorations and quick
little build-ups like this one.
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Photo Essay: The Pursuit of BruxZir Anterior Esthetics25