PFM Preparation - Acadental Tooth #30 | Dr. Richard Stevenson
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- Опубликовано: 22 июл 2024
- This video is about the PFM Preparation on tooth #30 Acadental ModuPRO One typodont. The prep starts like an FGC, and then the shoulder is added and blended with the existing axial walls.
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PFM Preparation - Acadental Tooth #30 | Dr. Richard Stevenson
#stevensondentalsolutions #pfm #pfmpreparation
Thanks for watching! 
Кино
Can never thank you enough for these videos. I've watched them dozens of times and still learn something new every time.
Best
Thank you! Best wishes, Dr. S
Great to have you back doc.
Spot on like always doc. You are like the Bob Ross of preps. Keep painting happy smooth margins!
Will do!
Ns
Very explicit! I’m so glad I found your channel!! :)
Great!
This is the best video i ever watched! Thank you so much Dr!!!
Wow - thank you!
Hello doctor it was a pleasure learning pfm from you. Best regards.
Thank you Doc! Wish you the best.
Thank you Dr. Stevenson for your work..
Your videos very helpful for us wish you to continue..
Dr.abbas for Iraq wish best for you 🌷🌷
Hi Doctor - thank you! Keep watching!
Thanks for your educational video,I just need your advice about the distal preparation, because that my point of weakness.
This looks so good. Thank you for sharing.
Thank you, Doc.
Awesome 😍 thanks for sharing , waiting for more and more
Thank you, Doc! More coming!
Thank you Dr S. Very helpful as always.
Great - thank you for watching.
Thank you so much, Dr. Stevenson! :) you help me in dental school a ton! :) Faith.
Awesome - thank you for your comments!
Simply superb. Thank you doctor. I learned a lot.
So nice of you - thank!
Thank you, Doc.
fantastic work doc. hope i can prep a pfm crown like yours. it's beautiful
Thank you Doc - keep at it!
i hope you can show all PFM prep of the teeth. that's what we'll be prepping for the board exam.
As always meticulously done, great work, best demo, thanks dr Stevenson!
Thank you Doctor!
Thank ya we learned a lot from your channel
Wow... don't think I will be able to do this .....too perfect
Keep at it - you'll get there!
Gute Arbeit, super👍
Thank you!
Thanks Dr you are amazing!
My sincere pleasure - best, Dr. S
Amazing prep doctor, may I ask how you decide on the angulation of the bur when starting the occlusal reduction?
Thank you so much for your videos!
I use the existing inclines of the triangular ridges, about 30-35 degrees.
Beautiful work.
Thank you, Doctor!
@@StevensonDentalSolutions Dr. Stevenson, could you show us how to do diastema closure on a typodont? Please and Thank you.
@@kevinpham3087 In the queue!
Alot of thanks dear dr 🌹
Happy to help!
perfect doctor stevenson
Oh trying anyway...but thank you.
Thank you well demostrated.
Thank you, Dr. S
Thank you Doctor, I watched this video may be ten times and the interesting thing is that every time when I watch I found a new thing to learn. By the way I had a chance to be one of your courses and can say that your fingers work just like a drils in CAD/CAM machin chamber. Highly recomend to attend his courses.
Thank you Arshak. Wishing you the very best with your upcoming exams.
Ur videos r incredible sir
Pls make videos of crown prep of lower premolar for pfm
I have learnt a lot from ur videos
I will do this - thank you Doctor.
Thanks doc for sharing such a piece of art..... please make n share a video of vaneer specially upper right canine
Many thanks
Stay blessed
Yes! I shall!
@@StevensonDentalSolutions ....I'll wait for that
Bjr dr. Pouvez vous me montrer l'orientation de la fraise sur la face vestibulaire svp ? Comment pousser la limite en sous gencive sans créer de contre dépouille ?
Nice work😊👍
Thank you Doctor!
Hi Dr! What a nice & precise prep! I would
like to ask, if there’s no RGS instrument to check on the clearance, what other ways we can make sure that we are cutting at the exact depth? Thank you
the back of all friction grip burs measure 1.6 mm
Good job
Thank you for sharing your video.
When preparing with high speed handpiece, should I move hand piece from mesial(or buccal)to distal(lingual) slowly?
Yes - I think you got it
Thank you doc.
My pleasure Doc!
Wonderful work ) tnx
Thank you Doc!
Thank you for your great videos. Do you have a video on preparations for a fixed partial denture? How to check for path of insertion, how to reduce, etc. Thank you.
ON our website we do: stevensondentalsolutions.com
Thanks a lot!
Great videos. When finishing your margins, what speed are you running the handpiece at? If at slow speed, are you using firm or light strokes? Thanks!
Very slow - stall out speed with the air turbine, and 2000 on electric.
Excellent doctor!!! Thank you so much for this great videos 🥰👍🏻
Thank you Doc!
Thanks doctor Stevenson, it was really helpful!
Can we just creat a shoulder finishline in buccal side at the begining; I mean not creatjng the chamfer at first??
Yes, for sure.
Thank you So much Sirrr,,,,,It would be great if you could teach us how to prepare a tooth for an Endocrown...,
I will - this is a great topic - it's on my list!
Thank you So much Sir....,,,,
What bur I need to use to get a chamfer margin of width between 0.3 to 0.7 doc? And can I use half of the round end taper bur or need to use only torpedo bur? Please advise. Thank you in advance
The 877-010 is a parallel pointed diamond 1.0 mm in diameter and this will give you a 0.5 mm modified chamfer. If you would prefer a tapered chamfer bur, use the 878K-016 which will give you a 0.55 mm chamfer if using half of the tip diameter. Round ended diamonds don't give chamfer margins - they create fillet finish lines, which are more like a rounded shoulder.
Very informative and so very well made. I just had 2 questions:
1) How do you maintain the anatomy of the triangular ridges when doing the plane reduction? I usually end up with pretty flat looking triangular ridges
2) When you are reducing the "B plane" are you are angling the burr parallel to the inclinations of the cusps like you did the in the "A plane" or is it perpendicular to the occlusal surface (making it flat)?
Thank you!
I try to preserve the most prominent triangular ridges, like the maxillary buccal cusps and the lingual mandibular cusps. If the triangular ridge is fairly flat, I usually respect that form. As for the B plane, it would ideally parallel the triangular ridge declination angle - about 35º. When you respect the inclination angles, the prep will have more uniform clearance and preserve more tooth structure.
Doctor, in the axial reduction I always make finish line too big and a lot of tooth structure lost, how do fix this ?
Try to use the bur no more than 1/2 of the diameter for the chamfer and only the tip for the shoulder. Let the bur limit you...
What if I moved the end of shoulder line beyond the contacts, would this be considered as wrong ?
it's aggressive and unnecessary to hide the metal collar.
Hi Dr,
For the chamfer refinement step here with the 8877-009 bur, do we do it on just the buccal wall or is to be done on the lingual as well?
Lingual only
The facial wall will be a shoulder
Hi Dr. Stevenson -- I'm wondering if you might share your dental CV. I would love to learn more detail about your continuing education efforts and career. The link on your website, re: Biosketch pdf, does not currently work. The videos and tips are excellent!
I'll update the link - thank you.
Hi doc. Please can you explain what does the 016 refer to on the 847kr 016 bur? You mention 1.2mm tip but I was under the impression the 016 referred to 1.6mm diameter at the tip.
The diameter of the WIDEST part of the bur in tenths of millimeters.
How do the codes of all the burrs make sense? I have trouble remembering which burr to use. :)
They are very strange. Whenever there is an "8" in front of the three numbers, it means fine grit (30 microns) Otherwise, the system of numbering makes little sense! KS was named after Kois and Spear. KR burs have rounded corners. It's a mess!
Beautiful. Can i use the 8847kr-016 but for the buccal margin for CERAMIC crowns? Ie a modified shoulder?
Yes for sure!
Hello doctor! Can you kindly describe the A plane, B plane, C plane locations?
A plane = functional cusp bevel
B plane = interior incline reduction
C plane = non-functional cusp incline reduction
Maxillary Posterior teeth: A plane is on the lingual of the lingual cusps and parallels the C plane, with is on the facial cusps, lingual inclines. The B plane is on the facial incline of the lingual cusps.
Mandibular Posterior teeth: A plane is on the facial of the facial cusps and parallels the C plane, with is on the lingual cusps, facial inclines. The B plane is on the lingual incline of the facial cusps.
Fantastic and indepth explaination for every step including the bur size. Every video i see has new information in it. Thank you Sir for this commendable videos. Just had a doubt. As for shamfer using 8877 o09 it has max width is 0.9 and we need shamfer of 0.5 - 0.7 so when we use half of the bur it will give only 0.45 max. Going further deep won't it create a lip on the outer rim ??
Great Question! It may if you don't manage it. All burs will create a lip if they go deep enough axially and are allowed to move gingivally. If you can plane the finish line by moving the diamond axially and outwardly, the lip will be corrected. If you'd prefer, you can use an 878K-014 or -016 as these will create taper and avoid lips if used less than half of their diameters. Alternatively use an 8877-010 - these will create a 0.5 mm axial depth at the finish line.
@@StevensonDentalSolutions Thank you Sir for your quick and proper answer. Keep it going Sir
Hi, dr
You used the red bur refining chamfer, is it possible to reduce the tooth with the red band bur?
You used the FG low speed angle handpiece or electric motor, creating shoulder.
Yes, and it's in a slow speed
Thanks for the video, from buccal aspect we can't appreciate the distal cusp unlike your previous videos of FGC. This is the issue usually I face as as well. Any comments on how important is it from examination point of view?
It was not an issue Ankur, it was as required. If you reduce the occlusal properly, and then you prepare the proximal and develop the taper - and if the distal cusp is prepped away, it was meant to be. With the FGC video, it was on a Columbia typodont, which has a much larger distal cusp. This prep was done as dictated by the environment. This is what's important from an examination point of view...
@@StevensonDentalSolutions Thanks for your views.
Great like always doc my question is for breaking contact we should keep the bur parallel to line of draw ? Bc for the distal you leaned the bur a little bit ? Is that something you for distal or its the camera angle thanks alit doc
Good observation! When breaking contact I use a very narrow diamond - the tipping is done to protect the adjacent tooth. After the contact is broken, you may start by holding the bur parallel to the line of draw, however, this will only provide about 6-7 degrees of Total Occlusal Convergence - not practical. The finest preps usually have 10-12 degrees of TOC and are completely acceptable with up to 20 degrees of TOC. Also, it is important to tip walls to obtain clearance with the proximal tooth contour...Thank you
@@StevensonDentalSolutions
Good bless you doc …. I usually use 169 bur to break contact and then try ti increase taper using 856 016 ….
Hello when doing the c plane do you reduce by 1.5mm? As its the buccal reduction
Yes
Hi Dr,
for buccal and lingual axial walls reduction, should the 878k-012 bur be inserted completely (entire diameter of the bur)? And how much should the buccal and lingual axial walls reduction be? 1.5mm?
Yes. The reduction will be about 1.5 mm
Hi Dr. Stevenson, Thank you so much for another great video! When you used 8847KR to create a shoulder, do you think the tip of the bur might create a sharp buccal cervical line angle that can potentially cause additional stress on the tooth's structure?
Not the KR - this has a rounded end, but PFMs need this axial depth, so there isn't much we can do. With all-ceramic preps, the KR burs are too aggressive and a fillet margin, using an 856-016 or KS type would be better as you mention.
@@StevensonDentalSolutions Got it. I didn't know that KR has a round end. Thank you so much for the info, Dr. Stevenson! You have a great weekend.
@@ruarua2603 Thank you!
Nice & neat!! How professional!
Thank you, Doc!
Tnx for your teaching.Are we use same burs in the amalgam restorations or bridge prepration?
Amalgam: 330, 245, 55, 169L, and 330RGS. Bridge: the same burs shown here.
@@StevensonDentalSolutions tnx so much
Perfect & smooth , i watch video time after time with passion , i have question dr , what is ur opinion about verti prep ?
It's controversial - let's wait for the research on this design. Most of us in Academics are concerned because it results in a knife edge of zirconia, and zirconia doesn't perform well when thin...
Thank you very much for your effort...
I have question.... what is the type of the loupe you use .and how much the magnification?
6x or a microscope with up to 30x but I started with 2.5x, then increased to 4.5x after a year or so. I usually recommend 3.5x Univet Prismatics with a light.
Do you sell it in your site..... ?
@@frozenlight8853 No it requires a rep to visit you and measure your eye and working distance. Check out Univet's website for more info
Hello doc, during preparation on patients mouth, where should I rest my fingers to garner support??
Take a look at my chair position videos (2 of them) and if you still have questions, let me know!
amazing❤❤❤❤❤
Thanks!
Hi how do I make my margins smooth???esp on dL and ml area
A secure finger rest, proper orientation, slower speed, practiced movements before engaging and...hundreds of preps.
I am right handed. I was preparing tooth no.15. It is very difficult to get accessibility and the buccal mucosa is fat, bulbous and difficult in retraction. Any advise!?
Rubber dam helps for some of the prep - then remove the dam - use a W3 or W2 clamp and do as much as possible, then remove the dam. Or...try an Isolite - they work great. If neither of these is working, then have the mirror slid between the tissue and the handpiece and have the patient perform a mandibular LEFT border movement which should open the area slightly.
hi dr. Stevenson, great video! Which chair position do you recommend for #30, especially for the B plane?
Start ay 7 for the C and A, then switch to 11 for the B
@@StevensonDentalSolutions Dr. Stevenson, how might the operator chair position change for each occlusal plane when doing this prep on #19 rather than #30?
I usually work from 7 O'clock to start the planes with direct vision, then swing around to 11 to refine with the patient's head turned towards me or away to facilitate the prep access
Stevenson Dental Solutions thank you Dr. Stevenson, your video has officially saved me the night before a crown competency! Bless you!
@@danielanaumovski6586 YES! So happy to help!!!
Hi Dr,
When reducing the buccal and lingual walls, do we hold the bur parallel to the long axis of that particular wall or do we tilt it towards the tooth to create that tapered effect? or does the tapered effect come with the design of the bur?
The bur will give you 6 degrees of total occlusal convergence, but this is the absolute minimum taper and if not done without flaw, you can easily have undercuts. My recommendation is to tip the bur slightly more than the inherent taper to create a TOC of about 12 degrees. This will provide you with adequate retention and ease of visualization. The secondary planes at the occlusal 1/3 of the facial and lingual are done at a great taper to follow the adjacent tooth contours.
@@StevensonDentalSolutions for the lower molar the lingual wall is tipped lingually..so the bur inclination is parallel to the long axis of that wall or do we tilt the bur inwards towards the tooth for taper?
Dr Stevenson, on your FGC preparation video (FULL GOLD CROWN in 7 STEPS
), you reduced the B plane after the C plane, whereas in this video you reduced the A plane after the B plane. I'm wondering does the order matter?
I like to show different approaches so dentists may make there own decisions...It really doesn't matter, as long as you keep your depth planes controlled and follow the original inclines. Thank you!
Hello Dr.Stevenson,
Please correct me if I am wrong..for a PFM, after axial reduction all around the tooth with 878k-012 the next step is to use 8877-009 only on the lingual wall and 8847KR-016 only on the buccal wall.Is that right?
bring the 8877 into the inter proximal too, and yes, use the 8847 or 8847KR for the facial esthetic zone areas.
@@StevensonDentalSolutions thanks alot!
Beautiful work. Can I use 847 bur for porcelain shoulder instead of the 847KR you have in the video? And the axial reduction bur too, I’m using 878 bur instead of the 878K you have in the video. Thankyou very much.
You're all set then - the differences are subtle and won't make a big difference!
Stevenson Dental Solutions got it, Thankyou . Just wondering the difference between these bur. Btw is the endo access video coming up anytime soon? :)
The 847 has a slightly sharper corner compared to the slightly rounded corners of the KR version. Endo access done - editing is underway...
Stevenson Dental Solutions for endo access what are & kinds of dental bur I should bought? Is it available is your stevendentalsolutions.com ? Thanks
Just the 2 round and 4 round bur, followed by the EndoZ - we don't currently carry the EndoZ
Beautiful doc …. Any recommendations for lower first premolar bc once you cut 1.5 mm and supraginguval margin you end up about 2 mm crown prep length is that ok ? Any advice ??
It is a short tooth for sure, so make sure you extend the finish line to the tissue level and keep the walls at 6-10 degrees. Best wishes, Dr. S
@@StevensonDentalSolutions thanks alot doc you such an inspiration for me to keep practicing and do better
@@StevensonDentalSolutions btw doc do you think 847 016 give 6-10 degree taper or more
Hi #Dr.
What FGC mean?
And what the difference between FGC & PFM? (except the finishing line in esthetic zone..)?
Full Gold Crown. FGC has less occlusal clearance and a chamfer margin.
@@StevensonDentalSolutions
Thanks Dr.
@@StevensonDentalSolutions
Dr. Which type of finishing line you use in zirconia crown...?
@@El_mahdi313 A radial Shoulder - a shoulder which is rounded internally and is at least 0.8 mm wide.
Perfect :)
Not really, but thank you!
What if skill tests like NDEB dont have needle burs to break contact. What would be our options? They only provide round end taper and flat end taper both 16 C.
If you can place a matrix between the teeth this might help - otherwise the entire batch will be prepping deeper axial walls and the examiners will be expecting it.
@@StevensonDentalSolutions Thanks for your advice. This NDECC exam in Canada for foreign dentist is really challenging. Hope the more relaxed grading criteria make it easier.
@@samjam6989 I am aware...best wishes!
Please can you explain what 'high speed at stall out speed' procedure is? How do I achieve this during margin refinement?
Push the pedal slightly - allow the headpiece to rotate more slowly.
My push foot pedal is sensitive so it is difficult to maintain a slow constant speed.
Can you try a friction grip slow speed attachment for your slow speed motor?
Yes I will look into getting a friction grip attachment. Many thanks for the advice.
@@aamin6933 Great
Sir, it looks like supra gingival margin, so i think junction will be visible. Is it?
Yes you are correct! This design is what schools use to test students, but rarely would be used clinically due to esthetics.
@@StevensonDentalSolutions Thank you sir
awesome
Thanks!
Dear Dr Stevenson Sorry I can’t read all the comments .. and maybe somebody already asked about the A plane , how deep did you go? 1.5 mm?
Yes, 1.5 mm
ah. it is hard to prepare the lingual margin using this bur
thx for the video
Yes, agreed - it gets easier with time.
Thanks for encourage~@@StevensonDentalSolutions
sir , what you think about Reverse Prep Technique ?
It's cool - especially helpful for developing proper margin depth for shoulders
@@StevensonDentalSolutions would you please post a vidio on it
I sure will!
Dear Sir,
It seems that these are electric handpieces? Not air-driven handpiece? Thanks
Air
@@StevensonDentalSolutions Thank you very much for your attention. I am lecturer, so we worry about that more dental faculties (US, EU) recommend dental student use electric handpiece (and air) during preclinical training (also in clinic). It is correct?
It is very difficult for me to teach dental student how to control very slow rpm like your clip (with air handpiece)
@@phanhung9622 Yes, it takes many years to master.
@@phanhung9622 True. The US has almost completely moved to electric in dental education. In practice, I , maintain both air and electric.
Burdan salim ağama sevgiler
very nice but in real practice most teeth that needs to be crowned is badly broken and/or large filled and can not do idialy prep on it !!
Oh, really? Hmm - try a block out to full counter and prep from there - it's possible doc! You don't know what you don't know...as Dr. Tucker would say.
@@StevensonDentalSolutions bloack out before prep !!!! , nice idia but we are in 3rd world and take 50$ for pfm and we pay more than half price to the lab
So sorry - please accept my apologies - I have no idea.
Didn't like the transition part, i always prefer wings
Awesome
Law of attraction: this pfm crown prep
Cute - thank you