Indirect and Direct Restorative Protocols - Caulk

››Principles & Practices
Appropriate Bur Selection:
Proper Tooth Reduction
for Indirect Restorations
››Abstract:
The continued evolution of
dental adhesives and resin
cements has modified the
way clinicians approach the
tooth preparation required
for indirect restorations.
While the biomechanical,
micromechanical, and chemical
properties of these adhesives
have increased the potential for
conservative tooth preparation,
the instrumentation used to
create such preparations
must still perform the
desired tooth reduction. This
presentation highlights the role
of proper bur selection in fixed
prosthodontic care.
The biomechanical, micromechanical,
and chemical properties
of contemporary dental
adhesives and resin cements
enable practitioners to adapt a
more conservative approach to tooth preparation.
In each such instance, the type of
restorative procedure being performed will
dictate the clinician’s choice of appropriately
sized and shaped instrumentation.
■ ■Straight, flat-end burs—Multi-
Prep carbides (DENTSPLY Professional,
York, PA) facilitate effective
removal of existing composite, metal,
or porcelain restorations. Their
cross-cut shape ensures removal of
debris from the preparation site and
requires less force to achieve the desired
cutting action.
■■Tapered, dome-end carbides—This
MultiPrep shape enables rapid, efficient
removal of composite resin,
porcelain, and natural tooth structure
and produces the divergent
preparation walls required for allceramic
crowns and aesthetic intracoronal
restorations.
■ ■ Flame-shaped, safe-end burs—
In order to reduce the potential
of injury to gingival tissues, some
Midwest® burs such as the Flame
include a smooth, non-cutting end
that is less likely to cause damage or
irritation when used at the gingival
margin.
In consideration for the varying tooth
sizes among pediatric and adult patients,
as well as the occlusal clearances that differ
among younger and geriatric patients,
it is also important to select a bur with the
right shank length and style. Midwest®
MultiPrep Burs (DENTSPLY Professional,
York, PA) are available in numerous
sizes and shapes to ensure the right option
is available for the anatomical requisites of
a given patient (Figure 1).
When treating previously restored
dentition, care should be taken to select
Figure 1. Prior to initiating tooth reduction, care should be taken to
ensure that the bur is properly secured in the handpiece chuck.
Figure 2. Midwest ® dome-shaped crosscut burs facilitate removal of
amalgam or other existing restorative materials and allow for easier
entry into the tooth than flat-end burs.
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