I have found that a small dental spoon works well as a cord packer! Gingival retraction gel is also beneficial if the procedure can be timely (we all know that's always the case). Thank you Dcotor!
spoon excavator makes for a great packer and allows you to "tuck" the cord into place. Can also do a two handed walking technique where the last portion of packed cord is held in place with a perio probe while the next portion is getting packed with the spoon - particularly useful in cases where the cord keeps popping up as you're packing it. With packing teflon, wetting your instrument helps prevent it from sticking to your instruments. When using teflon I found that the force required to pack is greater and has to be held in place for a couple of seconds before advancing.
99% of the time when there’s an old restoration unless it’s truly perfect I remove all of it. If I’m taking responsibility for the tooth now, I make sure the whole restoration is done by me. That way, I’m sure, and not relying on someone else (i.e. whether the previous dentist did complete caries removal, proper preparation, bonding, etc).
I’m a new grad dentist that’s been working for a few months now and been putting a lot of these tips into practice! Love RMGI for these - I put a bit of bond over and cure at the moment to protect once I’ve finished shaping but fluoride varnish is something I never thought of but makes a lot of sense too
Congratulations on graduating. Often I’ll use fluid varnish over other teeth as well because frequently these types of patients are high carries risk as well.
lol. I never thought of it like that. Great question about the RMGI. I prefer to use it on subgingival cases bc I find it easier to create a solid restoration compared to composite and esthetics weren’t critical in this case. If esthetics were an issue - it would be composite or a sandwich technique.
i sometimes struggle with isolation during buccals restorations because most cativies ive encountered extend to subgingival area. I'll surely try packing teflon next time, thanks for the tip doc ❤
These restorations are the bane of most dentist, I think. Especially when it starts bleeding, now what? Please give it a shot and let us know how it worked.
Thanks for the tips Dr. Ash. I use the periodontal probe for packing, also I use GlC if the decay is extended subgingival, and I do my polishing with white stone. I'm going to use fluoride varnish next time to maximize the setting efficiency on my next patient.
Thanks so much for the comment. I should’ve mentioned that covering the glass ionomer just helps it not absorb water while it is setting. www.ncbi.nlm.nih.gov/books/NBK582145/#:~:text=Protection%20of%20the%20cement%3A%20the,first%2024%20hours%20of%20setting.
Great question. RMGI restorations are sensitive to water absorption before they are fully set. Composite cures typically almost instantly (light cured ones). The purpose of the varnish or coating is to prevent the RMGI from absorbing water before it’s fully set. Adding flouride varnish to a composite won’t help the composite - but it may influence the tooth structures surrounding it.
Dear Doctor Ashley If you can shade some light on this topic, we are seeing many videos where they don't use a liner on deep cavities, I'm personally not convinced by this approach.
Great question. I still use a liner here and there - however, I have really leaned on immediate dentin sealing (I have it in my own teeth). Do you know what I'm talking about?
Video was nice, it would have been MUCH better if you had spent more time on the completed work, and NOT have blocked most of it out with your "promotional box." Doctor Whitehead
Thank you to those who have taught me these tips. I"m super grateful.♥
I have found that a small dental spoon works well as a cord packer! Gingival retraction gel is also beneficial if the procedure can be timely (we all know that's always the case).
Thank you Dcotor!
OMGOSH. Lol. I used the spoon bc that’s what I had. Thanks for the comment.
spoon excavator makes for a great packer and allows you to "tuck" the cord into place. Can also do a two handed walking technique where the last portion of packed cord is held in place with a perio probe while the next portion is getting packed with the spoon - particularly useful in cases where the cord keeps popping up as you're packing it. With packing teflon, wetting your instrument helps prevent it from sticking to your instruments. When using teflon I found that the force required to pack is greater and has to be held in place for a couple of seconds before advancing.
99% of the time when there’s an old restoration unless it’s truly perfect I remove all of it. If I’m taking responsibility for the tooth now, I make sure the whole restoration is done by me. That way, I’m sure, and not relying on someone else (i.e. whether the previous dentist did complete caries removal, proper preparation, bonding, etc).
Hey ash, I actually prefer to use a matrix in these situations, a modified tofflmire /unica-like, always perfect gingival margin with this matrix..
rubberdam?? +Brinker b4.. and perfect dry conditions 😊
Great point. I elected no RD in this case bc I end up pulling the RD apically and it’s sometimes a headache.
I’m a new grad dentist that’s been working for a few months now and been putting a lot of these tips into practice! Love RMGI for these - I put a bit of bond over and cure at the moment to protect once I’ve finished shaping but fluoride varnish is something I never thought of but makes a lot of sense too
Congratulations on graduating. Often I’ll use fluid varnish over other teeth as well because frequently these types of patients are high carries risk as well.
Which company this white stone bur?
Thanks
what happens with water absorption in first 24 hrs?
Dude u extract teeth with RD but do a filling without ? i dont understand .... and why would u use GIC .......
lol. I never thought of it like that. Great question about the RMGI. I prefer to use it on subgingival cases bc I find it easier to create a solid restoration compared to composite and esthetics weren’t critical in this case. If esthetics were an issue - it would be composite or a sandwich technique.
What type of GIC company did u use here? Was it SDI?
Also the stone bur which company?
This is Fuji II and the stone is from Shofu. www.shofu.com/en/product/dura-white-stones/
i sometimes struggle with isolation during buccals restorations because most cativies ive encountered extend to subgingival area. I'll surely try packing teflon next time, thanks for the tip doc ❤
These restorations are the bane of most dentist, I think. Especially when it starts bleeding, now what? Please give it a shot and let us know how it worked.
Thanks for the tips Dr. Ash. I use the periodontal probe for packing, also I use GlC if the decay is extended subgingival, and I do my polishing with white stone. I'm going to use fluoride varnish next time to maximize the setting efficiency on my next patient.
Thanks so much for the comment. I should’ve mentioned that covering the glass ionomer just helps it not absorb water while it is setting. www.ncbi.nlm.nih.gov/books/NBK582145/#:~:text=Protection%20of%20the%20cement%3A%20the,first%2024%20hours%20of%20setting.
I like to use round non pointed explorer😂😂😂, for many years i feel its effecient tool for packing the ging cord.
Wow. I was really expecting cord packers tbh. Its everything but that
Perfect
Thank you for this !
is flouride varnish can be applied to composite too ?
Great question. RMGI restorations are sensitive to water absorption before they are fully set. Composite cures typically almost instantly (light cured ones). The purpose of the varnish or coating is to prevent the RMGI from absorbing water before it’s fully set. Adding flouride varnish to a composite won’t help the composite - but it may influence the tooth structures surrounding it.
what flouride varnish do you prefer@@AllThingsDentistry
@@AllThingsDentistry yes got it , thanks dr ❤
R U general dentist..
If yes how U deal dentistry at such at advanced level mostly prostho.
Curious to know.
Any evidence on the application of fluoride varnish on RMGI ?
Yeah that one was a new one to me too. What's it supposed to do?
@@RossWilliams89 what is the norm is apply some petrolgel
Its weird that you don't use rubber dam here. I saw you use rubber for extraction and even bone augmentation
Nice work Docteur 👍
I want to know the type of teflon used in dentistry please…
Thank you
tried out the Teflon tape just then for a little Cl5, game changer! I used a flat plastic to pack :)
Has anyone found a way to stop the Teflon sticking under flash of your composite or gic restoration?
awesome tips! thank you for the amazing content as usual!
You should try Cord packer corcicoma doc 😊
Amazing tips,thanks sir❤️
thanks it was really helpful
IPC for packing 100%
Wow. An IPC. I’ll have to try that
Same here. IPC 100% of the time.
Let me know how you like it @@AllThingsDentistry btw great vids
Dear Doctor Ashley If you can shade some light on this topic, we are seeing many videos where they don't use a liner on deep cavities, I'm personally not convinced by this approach.
Great question. I still use a liner here and there - however, I have really leaned on immediate dentin sealing (I have it in my own teeth). Do you know what I'm talking about?
@@AllThingsDentistry yes i understand , ids probably needs very high quality bond too , no patient reported post op sensitivity ?
Nice one!
Video was nice, it would have been MUCH better if you had spent more time on the completed work, and NOT have blocked most of it out with your "promotional box." Doctor Whitehead