RGMI, not GIS. Extremely long term bond to dentin and enamel, both chemically and micromechanically - resilient over time, resistant to water sorption, biocompatible, not vulnerable to MMPs, etc. In cases where the block out is very thin, like in this case, I use RMGI, when the block out is thick, I use RMGI, then bonded composite (with a six-generation system).
Question first thanks so much for your dedication and sharing your knowledge and artistry with us, Dr Stevenson for final impressions would you recommend using digital impressions (primescan owner) will it be as accurate also which lab do you use? Thanks 🙏 so much
For gold, the precision of scanners will not work well - use traditional PVS material. Scanners (I have two of them) will not capture the retentive areas well, like slots, pin holes and internal v]bevels. Also, the math in the software estimates and assumes too much. I make my own castings.
Thank you Dr Stevenson for this great video question before placing the duraseal you mentioned you placed some dental stoppers can you share the name and are they easy to remove once the duraseal hardens? Would love to see how you finalized the temps thanks so much!
I use dental stopping in the gingival sulcus areas - simply warm it over a flam and place a small amount to protect the gingiva from the DuraSeal. After a few weeks when seating the case, the DuraSeal and Dental Stopping is easy to remove with a spoon. The DuraSeal stays plastic throughout.
This clinical series is on fire! 🔥🔥 Please, I have an irrelevant question doctor: In your amalgam prep videos, you were using the RGS 330 bur after the 330, to define the internal line angles. I was wondering is it okay to prep only using the 330 or using 245 (which has a slightly flatter base)? In Sturdevant's book, it's mentioned that the 245 will create slightly rounded internal line angles, which reduces the stresses. What do you think doctor? And what are the alternatives if I don't have the RGS330? THANKS IN ADVANCE 😀
The 245 is great, but the tip is not flat, whereas the 330 RGS is. Both create the required rounded line angles for amalgam. A hack is to use a heatless stone on slow speed to flatten the tip of a 245 - VBoila - you now have a 330 RGS...almost.lline
Great question! The 170 and 171's have wide upper portions and narrow lower portions and cut more aggressively at the top and tend to leave scalloped marks on the pulpal. Also, they only create 7 degrees of total occlusal divergence if held parallel to the line of draw, which really isn't enough to get passive removal of the wax patterns without distortion. The 56 allows the dentist to design the taper required, rather than rely on the bur. Having said this, I do in fact love the 171 or even the 172 on slow speed for difficult access cases, like the distal wall of a terminal tooth. Wishing you the best!
Dr Stevenson your videos are very educational I keep seeing them all the time. I have a question. Would you consider digital impressions for accuracy instead of rubber based impression materials? Please share Pros and Cons too. Thank You so much for all your efforts.
Digital impressions are excellent, and I use two scanners in my practice, Trios 3Shape, and Itero. For cases on isolated quadrants or sextants, their accuracy is well-documented. These same studies show that full arch scanning is acceptable for guides and retainers, aligners, and nightguards by not accurate enough for fixed prosthodontics, at least without try-ins with sectioning and adjustments. I believe that we will get there soon. Also, the way in which you scan has an impact on the cumulative error issue with digital impressions - better scanning technique = better accuracy and precision. For precision gold castings, I need to take an analog impression because the printed models at not precise enough (about 10-25 microns is not precise enough). I use a stone that only expands 0.07% and a careful technique with phosphate bonded investment and well-calibrated burn out temperatures. The results produce castings with submicron (!!) margins. It would be possible to send the digital impression to a gold milling lab, but these are very costly services and I have not had the best results. I also like analog impressions when the tissue is an issue - I can flow the PVS material into the sulcus quickly and secure the margin where scanning takes more time to place the scanner in the mouth over the prepared margin. Hope this gives you a small glimpse into my philosophy.
@@StevensonDentalSolutions Dr.Stevenson, what gypsum do you prefer for higher precision (gold inlays), and do you happen to sell a book with all the materials you prefer, so that we can base our practice on those? Thank you. 🙃
Thank You so much Dr Stevenson. Your clinical judgement on to how to use the scans and impressions are amazing. I hope following your techniques and guidance we too reach a decent level of clinical skills. Appreciate your time and love for sharing your thoughts. Thank You so much!!!
With subgingival gingival walls, I sometimes will use a W00 clamp or B4 clamp on the tooth itself to retract the dam further, and place a short piece of retraction cord between the dam and the tooth to secure the seal and invert the dam. The hole spacing must increase about 2 mm as well to allow for enough dam between the teeth.
Always impressive control and quality of work! Thank you very much for sharing.
My pleasure Rodrigo!
my hats off for dr stevenson beautiful work as always
Thank you Doctor!
Beautiful
Beautiful work
Thank you Brenda !
Thanks dr, looking forward to the next video. Never learned inlay onlay in school and feel like I missed out!
Glad you like the video - more to come.
Great content, beautifully explained 👍👍
Thank you - I appreciate the support.
Fantastic!!
Thank you!
Excelente trabajo.
¡Gracias!
Looking forward to cementation! I remember the H248s from lecture!
Coming soon! You have a great memory!
عمل أكثر من رائع
Very good but I have a question Please why are you using GIM !!
RGMI, not GIS. Extremely long term bond to dentin and enamel, both chemically and micromechanically - resilient over time, resistant to water sorption, biocompatible, not vulnerable to MMPs, etc. In cases where the block out is very thin, like in this case, I use RMGI, when the block out is thick, I use RMGI, then bonded composite (with a six-generation system).
Dr. What can you use instead of that guttapercha for blocking? Also whats the brandname of that guttapercha you use ? Thank you
Hygienic Brand - you may use Ivoclar Telio CS instead of the DuraSeal technique, however, it more costly and a bit more difficult to remove.
Question first thanks so much for your dedication and sharing your knowledge and artistry with us, Dr Stevenson for final impressions would you recommend using digital impressions (primescan owner) will it be as accurate also which lab do you use? Thanks 🙏 so much
For gold, the precision of scanners will not work well - use traditional PVS material. Scanners (I have two of them) will not capture the retentive areas well, like slots, pin holes and internal v]bevels. Also, the math in the software estimates and assumes too much. I make my own castings.
Thank you for taking time to answer my questions :)
Thank you Dr Stevenson for this great video question before placing the duraseal you mentioned you placed some dental stoppers can you share the name and are they easy to remove once the duraseal hardens? Would love to see how you finalized the temps thanks so much!
I use dental stopping in the gingival sulcus areas - simply warm it over a flam and place a small amount to protect the gingiva from the DuraSeal. After a few weeks when seating the case, the DuraSeal and Dental Stopping is easy to remove with a spoon. The DuraSeal stays plastic throughout.
This clinical series is on fire! 🔥🔥
Please, I have an irrelevant question doctor:
In your amalgam prep videos, you were using the RGS 330 bur after the 330, to define the internal line angles.
I was wondering is it okay to prep only using the 330 or using 245 (which has a slightly flatter base)?
In Sturdevant's book, it's mentioned that the 245 will create slightly rounded internal line angles, which reduces the stresses.
What do you think doctor?
And what are the alternatives if I don't have the RGS330?
THANKS IN ADVANCE 😀
The 245 is great, but the tip is not flat, whereas the 330 RGS is. Both create the required rounded line angles for amalgam. A hack is to use a heatless stone on slow speed to flatten the tip of a 245 - VBoila - you now have a 330 RGS...almost.lline
@@StevensonDentalSolutions Thanks alot doctor, you always have the solution!
@@omargad7494 My pleasure!
Thank you for a great video . Could you please consider doing a video on treating tooth surface loss . 🙏
Like occlusal wear?
Stevenson Dental Solutions yes .
@@revanth3508 Great topic - will try!
Stevenson Dental Solutions thank you 🙏
Stevenson Dental Solutions Dr Stevenson ,would it be possible for you to ship the instruments available to buy from your online store to the U.K.?
Hi Dr. Stevenson. Are there any other onlay temporization materials that you recommended besides this one?
For inlays and onlays I really like TelioCS by Ivocvlar.
Just curious...why not use a 170 or 171 (tapered) in lieu of the 56 carbide?
Great question! The 170 and 171's have wide upper portions and narrow lower portions and cut more aggressively at the top and tend to leave scalloped marks on the pulpal. Also, they only create 7 degrees of total occlusal divergence if held parallel to the line of draw, which really isn't enough to get passive removal of the wax patterns without distortion. The 56 allows the dentist to design the taper required, rather than rely on the bur. Having said this, I do in fact love the 171 or even the 172 on slow speed for difficult access cases, like the distal wall of a terminal tooth. Wishing you the best!
Sr kindly upload the video of class2 amalgam cavity prepration
ruclips.net/video/Mw1L-s9ALz8/видео.html
how long do you book these appointments for? they seem to be very technically driven preps
I usually schedule 90 minutes for one prep and 2 hours for two preps. The skill set grows with mentoring and much practice,
Dr please can u tell me when I can found this in any book??any source??
Summitt's Operative Dentistry, 4th ed, Chapter 20
If you need more, please reach out to my email on my website...
@@StevensonDentalSolutions Thank you, Dr., I sent you an email
Dr Stevenson your videos are very educational
I keep seeing them all the time. I have a question.
Would you consider digital impressions for accuracy instead of rubber based impression materials? Please share Pros and Cons too.
Thank You so much for all your efforts.
Digital impressions are excellent, and I use two scanners in my practice, Trios 3Shape, and Itero. For cases on isolated quadrants or sextants, their accuracy is well-documented. These same studies show that full arch scanning is acceptable for guides and retainers, aligners, and nightguards by not accurate enough for fixed prosthodontics, at least without try-ins with sectioning and adjustments. I believe that we will get there soon. Also, the way in which you scan has an impact on the cumulative error issue with digital impressions - better scanning technique = better accuracy and precision.
For precision gold castings, I need to take an analog impression because the printed models at not precise enough (about 10-25 microns is not precise enough). I use a stone that only expands 0.07% and a careful technique with phosphate bonded investment and well-calibrated burn out temperatures. The results produce castings with submicron (!!) margins. It would be possible to send the digital impression to a gold milling lab, but these are very costly services and I have not had the best results.
I also like analog impressions when the tissue is an issue - I can flow the PVS material into the sulcus quickly and secure the margin where scanning takes more time to place the scanner in the mouth over the prepared margin.
Hope this gives you a small glimpse into my philosophy.
@@StevensonDentalSolutions Dr.Stevenson, what gypsum do you prefer for higher precision (gold inlays), and do you happen to sell a book with all the materials you prefer, so that we can base our practice on those? Thank you. 🙃
@@rodrigocartens7563 FujiRock buff (0.07% expansion) - No book (yet) but I will put t=something together soon and share it with you.
@@StevensonDentalSolutions Thank you very much! Have a great nigh doc.
Thank You so much Dr Stevenson. Your clinical judgement on to how to use the scans and impressions are amazing. I hope following your techniques and guidance we too reach a decent level of clinical skills.
Appreciate your time and love for sharing your thoughts.
Thank You so much!!!
how can we mange preparation if the gingival seat is subgingival ?
With subgingival gingival walls, I sometimes will use a W00 clamp or B4 clamp on the tooth itself to retract the dam further, and place a short piece of retraction cord between the dam and the tooth to secure the seal and invert the dam. The hole spacing must increase about 2 mm as well to allow for enough dam between the teeth.
How can we get in contact with your office? The phone number on Google doesn't seem to work
1310-868-1838
@@StevensonDentalSolutions 🙏